Basic Information
Provider Information
NPI: 1437881398
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: KAYLA
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: MS, CF-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1877 N PARIS AVE
Address2:  
City: PORT ROYAL
State: SC
PostalCode: 299352029
CountryCode: US
TelephoneNumber: 8439702899
FaxNumber:  
Practice Location
Address1: 1877 N PARIS AVE
Address2:  
City: PORT ROYAL
State: SC
PostalCode: 299352029
CountryCode: US
TelephoneNumber: 8439702899
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/29/2022
LastUpdateDate: 06/29/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/29/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X8030SCY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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