Individual
KAYLA MARIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS-CCC-SLP
Contact information
Practice address
7227 GOODMAN ST, OVERLAND PARK, KS 66204-1741
(913) 961-6380
Mailing address
7227 GOODMAN ST, OVERLAND PARK, KS 66204-1741
(913) 961-6380
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1761
NE
235Z00000X
Speech-Language Pathologist
Primary
3819
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47065477700
—
NE
Enumeration date
05/27/2015
Last updated
09/07/2022
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