Provider Demographics
NPI:1497245120
Name:NORRIS, KYLA M (SLPA)
Entity Type:Individual
Prefix:
First Name:KYLA
Middle Name:M
Last Name:NORRIS
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12419 N BARBADENSE DR
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85653-7729
Mailing Address - Country:US
Mailing Address - Phone:520-609-6116
Mailing Address - Fax:
Practice Address - Street 1:12419 N BARBADENSE DR
Practice Address - Street 2:
Practice Address - City:MARANA
Practice Address - State:AZ
Practice Address - Zip Code:85653-7729
Practice Address - Country:US
Practice Address - Phone:520-609-6116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty