Provider Demographics
NPI:1891277554
Name:SPALDING, KARA JANELLA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KARA JANELLA
Middle Name:
Last Name:SPALDING
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 1:3101 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-1238
Mailing Address - Country:US
Mailing Address - Phone:512-365-9398
Mailing Address - Fax:
Practice Address - Street 1:3101 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-1238
Practice Address - Country:US
Practice Address - Phone:512-365-9398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY243679235Z00000X
TX118374235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX118374OtherTEXAS DEPARTMENT OF LICENSING AND REGISTRATION