Provider Demographics
NPI:1528748662
Name:MCKINNEY, KAYLA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 MARYLAND PL
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-3093
Mailing Address - Country:US
Mailing Address - Phone:501-951-3159
Mailing Address - Fax:
Practice Address - Street 1:17 PARKSTONE CIR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7059
Practice Address - Country:US
Practice Address - Phone:501-801-9705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4183235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist