Individual
KAYLA DESUTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
7160 TCHULAHOMA RD STE B4, SOUTHAVEN, MS 38671-9268
(662) 349-2733
(662) 536-1849
Mailing address
636 DENMARK DR, MEMPHIS, TN 38103-4652
(662) 349-2733
(662) 536-1849
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3759
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S3759
STATE
MS
Enumeration date
10/28/2013
Last updated
10/28/2013
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