Provider Demographics
NPI:1598218836
Name:HIRST, KAYLA NICHOL
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:NICHOL
Last Name:HIRST
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 1:19 N LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-2160
Mailing Address - Country:US
Mailing Address - Phone:602-332-6550
Mailing Address - Fax:
Practice Address - Street 1:299 E RIVER RD
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-6400
Practice Address - Country:US
Practice Address - Phone:315-342-3166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist