Provider Demographics
NPI:1811233976
Name:WEST, KAYLA MARIE (SLP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:WEST
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:1416 29TH ST
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-2725
Mailing Address - Country:US
Mailing Address - Phone:870-588-7781
Mailing Address - Fax:
Practice Address - Street 1:1416 29TH ST
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-2725
Practice Address - Country:US
Practice Address - Phone:870-588-7781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18304235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR195732721Medicaid