Provider Demographics
NPI:1710501515
Name:WALTER-FRIEDE, KAYLEE (CCC SLP)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:WALTER-FRIEDE
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CAMPUS DR
Mailing Address - Street 2:SKAGGS BLDG #129
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59812-0003
Mailing Address - Country:US
Mailing Address - Phone:406-243-2405
Mailing Address - Fax:406-243-6678
Practice Address - Street 1:32 CAMPUS DRIVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802
Practice Address - Country:US
Practice Address - Phone:360-509-4837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist