Provider Demographics
NPI:1477850535
Name:BRACEY, KAYLA L
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:L
Last Name:BRACEY
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 1:802A 13TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-3816
Mailing Address - Country:US
Mailing Address - Phone:843-272-1486
Mailing Address - Fax:
Practice Address - Street 1:802A 13TH AVE S
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-3816
Practice Address - Country:US
Practice Address - Phone:843-272-1486
Practice Address - Fax:843-272-1493
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist