Provider Demographics
NPI:1295337103
Name:HIRSCH, KYRA DEANNA
Entity type:Individual
Prefix:MRS
First Name:KYRA
Middle Name:DEANNA
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KYRA
Other - Middle Name:DEANNA
Other - Last Name:LAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18934 US HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:OK
Mailing Address - Zip Code:73834-8907
Mailing Address - Country:US
Mailing Address - Phone:605-870-1482
Mailing Address - Fax:
Practice Address - Street 1:18934 US HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:OK
Practice Address - Zip Code:73834-8907
Practice Address - Country:US
Practice Address - Phone:605-870-1482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKSLPA2002355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant