Provider Demographics
NPI:1871268805
Name:BALDWIN, KAYLEE L (MS, CFY-SLP)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:L
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SW LANGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34984-4924
Mailing Address - Country:US
Mailing Address - Phone:772-828-1645
Mailing Address - Fax:
Practice Address - Street 1:1483 SW BOUGAINVILLEA AVE
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-7302
Practice Address - Country:US
Practice Address - Phone:772-336-6928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ10232235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist