Provider Demographics
NPI:1780067462
Name:DOWD, KAYLA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:DOWD
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 SUMMER ST
Mailing Address - Street 2:APT. 7
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-2226
Mailing Address - Country:US
Mailing Address - Phone:860-803-4996
Mailing Address - Fax:
Practice Address - Street 1:259 SUMMER ST
Practice Address - Street 2:APT. 7
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-2226
Practice Address - Country:US
Practice Address - Phone:860-803-4996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005005235Z00000X
MA9519235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist