Provider Demographics
NPI:1073330205
Name:FABELLA, KAYLA
Entity type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:
Last Name:FABELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:FABELLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:KAYLA FABELLA, SLPA
Mailing Address - Street 1:2039 45TH ST S APT B
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33711-3043
Mailing Address - Country:US
Mailing Address - Phone:224-538-1854
Mailing Address - Fax:
Practice Address - Street 1:11820 DENTON AVE
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-5419
Practice Address - Country:US
Practice Address - Phone:727-862-9101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI66602355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant