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Individual

MRS. KAYLA TIERNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, CCC-SLP

Contact information

Practice address
18 LAURELHURST RD, CRANSTON, RI 02920-8143
(401) 486-8206
Mailing address
18 LAURELHURST RD, CRANSTON, RI 02920-8143
(401) 486-8206

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
8874
MA
235Z00000X
Speech-Language Pathologist
Primary
SP01280
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SP01280
PRIVATE PAY
RI
05
SP01280
RI
Enumeration date
10/20/2016
Last updated
02/03/2023
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