Provider Demographics
NPI:1881965655
Name:CLIFFORD, KAYTE (MS SLP)
Entity type:Individual
Prefix:
First Name:KAYTE
Middle Name:
Last Name:CLIFFORD
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:KAYTE
Other - Middle Name:
Other - Last Name:NOWIKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:308 SIXTH AVE
Mailing Address - Street 2:
Mailing Address - City:INDIAN ROCKS BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33785
Mailing Address - Country:US
Mailing Address - Phone:727-510-3395
Mailing Address - Fax:
Practice Address - Street 1:9035 BRYAN DAIRY ROAD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777
Practice Address - Country:US
Practice Address - Phone:727-395-9619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA245235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist