Provider Demographics
NPI:1518671932
Name:SANEHOLTZ, KAYLA JANE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:JANE
Last Name:SANEHOLTZ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:JANE
Other - Last Name:CORNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:4131 E DUNBAR RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-9111
Mailing Address - Country:US
Mailing Address - Phone:734-497-6610
Mailing Address - Fax:
Practice Address - Street 1:4131 E DUNBAR RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-9111
Practice Address - Country:US
Practice Address - Phone:734-497-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101007959235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist