Kaylan Dekle
Individual provider Active NPI Speech-Language Pathologist · Perry, GA
NPI 1497345276 · NPPES record last updated Jan 25, 2021
Key facts
- NPI
- 1497345276
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- PCET003268 (GA)
- Practice address
- 225 Wes Park Dr
Perry, GA 31069-4829 - Phone
- (478) 987-1610
- Fax
- (973) 965-4580
- NPI assigned
- Jan 25, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCET003268 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Speech Path | Speech-Language Pathologist | Past |
Accepting new patients |
| The Speech Path LLC | Speech-Language Pathologist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | PCET003268 | GA | Yes |
Addresses
Primary practice location
225 Wes Park Dr
Perry, GA 31069-4829
Mailing address
225 Wes Park Dr
Perry, GA 31069-4829
Phone (478) 987-1610
Other providers in Perry, GA
- Laura Peyton Cunningham-Ward
- David Michael Cunningham
- Glenda H. Davis
- Lauren Dean
- Latifah K Decker
- Tony Monroe Deloach
- Dermatology Services of Georgia, PLLC
- Shireen Dhir
- Robert Dickerson
- Joe Mathis Dixon
All providers in Perry, GA · Speech-Language Pathologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.