Provider Demographics
NPI:1770006405
Name:HOFFMEISTER, KAYLA DAWN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:DAWN
Last Name:HOFFMEISTER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 HONEYSUCKLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-5610
Mailing Address - Country:US
Mailing Address - Phone:636-577-3221
Mailing Address - Fax:
Practice Address - Street 1:12303 DEPAUL DR
Practice Address - Street 2:1639
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044
Practice Address - Country:US
Practice Address - Phone:314-344-6000
Practice Address - Fax:314-344-7348
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015019204235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist