Provider Demographics
NPI:1477205946
Name:RAY, KYLIE LOUISE
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:LOUISE
Last Name:RAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11820 28TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:TX
Mailing Address - Zip Code:77510-8872
Mailing Address - Country:US
Mailing Address - Phone:832-967-7862
Mailing Address - Fax:
Practice Address - Street 1:8603 BROADWAY ST STE 170
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8171
Practice Address - Country:US
Practice Address - Phone:281-540-2001
Practice Address - Fax:281-540-2789
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX423232355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant