Provider Demographics
NPI:1841973898
Name:MITCHELL, KAYLEE (BS, SLPA)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:BS, SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 BUZZ ST UNIT 16
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-6730
Mailing Address - Country:US
Mailing Address - Phone:417-527-0523
Mailing Address - Fax:
Practice Address - Street 1:115 E CRANDALL AVE STE A
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-3629
Practice Address - Country:US
Practice Address - Phone:870-654-3869
Practice Address - Fax:870-505-2016
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20210364712355S0801X
AR2023732355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant