Provider Demographics
NPI:1699295493
Name:KIRK, KAYLA D (AUD)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:D
Last Name:KIRK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:FUZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-366-3687
Mailing Address - Fax:614-293-9698
Practice Address - Street 1:915 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3153
Practice Address - Country:US
Practice Address - Phone:614-366-3687
Practice Address - Fax:614-293-9698
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.02088231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist