Provider Demographics
NPI:1053604678
Name:WILLIAMS, KAYLA B (MCD, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:B
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BARN PLANK RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7494
Mailing Address - Country:US
Mailing Address - Phone:803-466-3561
Mailing Address - Fax:
Practice Address - Street 1:401 BARN PLANK RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7494
Practice Address - Country:US
Practice Address - Phone:803-466-3561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4864235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist