Provider Demographics
NPI:1457856429
Name:RYDALCH, KAYLA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:RYDALCH
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1082 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6758
Mailing Address - Country:US
Mailing Address - Phone:208-881-3633
Mailing Address - Fax:
Practice Address - Street 1:2550 ADDISON AVE E
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6767
Practice Address - Country:US
Practice Address - Phone:208-814-7950
Practice Address - Fax:208-814-7957
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist