Provider Demographics
NPI:1508263963
Name:CARLTON, KAYLOR (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAYLOR
Middle Name:
Last Name:CARLTON
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 1:6032 E 144TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-4011
Mailing Address - Country:US
Mailing Address - Phone:918-260-5894
Mailing Address - Fax:
Practice Address - Street 1:6032 E 144TH ST S
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-4011
Practice Address - Country:US
Practice Address - Phone:918-260-5894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3860235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist