Provider Demographics
NPI:1568973469
Name:KINA, TAYLER
Entity Type:Individual
Prefix:MRS
First Name:TAYLER
Middle Name:
Last Name:KINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAYLER
Other - Middle Name:
Other - Last Name:EPPLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:151 BUSINESS CENTER LOOP
Mailing Address - Street 2:STE A
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-8560
Mailing Address - Country:US
Mailing Address - Phone:808-650-0926
Mailing Address - Fax:
Practice Address - Street 1:911 BERN CT STE 130
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-1242
Practice Address - Country:US
Practice Address - Phone:408-437-8864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty