Provider Demographics
NPI:1942757539
Name:ORTON, KAYLA JOY
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:JOY
Last Name:ORTON
Suffix:
Gender:F
Credentials:
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 187
Mailing Address - Street 2:200 WILLOW ST.
Mailing Address - City:HARRISBURG
Mailing Address - State:SD
Mailing Address - Zip Code:57032-0187
Mailing Address - Country:US
Mailing Address - Phone:605-743-2567
Mailing Address - Fax:
Practice Address - Street 1:200 WILLOW ST.
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:SD
Practice Address - Zip Code:57032-0187
Practice Address - Country:US
Practice Address - Phone:605-743-2567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD663-SLP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1003991258Medicaid