Provider Demographics
NPI:1356867584
Name:KIRTS, KAYLA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:KIRTS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21630 MERCHANTS WAY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2514
Mailing Address - Country:US
Mailing Address - Phone:832-230-1518
Mailing Address - Fax:281-741-7355
Practice Address - Street 1:21630 MERCHANTS WAY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449
Practice Address - Country:US
Practice Address - Phone:832-230-1518
Practice Address - Fax:281-741-7355
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113958235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist