Provider Demographics
NPI:1184381253
Name:BRATCHER, KAYLA DANYELLE (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:DANYELLE
Last Name:BRATCHER
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 1:2737 N FITZHUGH AVE APT 3127
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-3330
Mailing Address - Country:US
Mailing Address - Phone:405-248-0090
Mailing Address - Fax:
Practice Address - Street 1:5757 ALPHA RD # 503
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4601
Practice Address - Country:US
Practice Address - Phone:405-248-0090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114845235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist