Provider Demographics
NPI:1346812484
Name:NICHOLS- STRICKLER, KAYLA LEANN (SLP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:LEANN
Last Name:NICHOLS- STRICKLER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-6210
Mailing Address - Country:US
Mailing Address - Phone:513-490-3643
Mailing Address - Fax:
Practice Address - Street 1:2603 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-6210
Practice Address - Country:US
Practice Address - Phone:620-789-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-16
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3362235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty