Provider Demographics
NPI:1619215266
Name:SHERRARD, KYLA COOPER (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:KYLA
Middle Name:COOPER
Last Name:SHERRARD
Suffix:
Gender:F
Credentials:PHD, 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:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:254-724-2111
Mailing Address - Fax:
Practice Address - Street 1:2401 S 31ST ST
Practice Address - Street 2:MS09-C400C
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508-4909
Practice Address - Country:US
Practice Address - Phone:254-724-4749
Practice Address - Fax:254-724-4631
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12571235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist