Provider Demographics
NPI:1811703366
Name:BISHOP, KAYLA MICHELLE
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MICHELLE
Last Name:BISHOP
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 6041
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24068-6041
Mailing Address - Country:US
Mailing Address - Phone:304-308-0331
Mailing Address - Fax:
Practice Address - Street 1:1995 S MAIN ST STE 801
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6637
Practice Address - Country:US
Practice Address - Phone:540-951-2703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist