Individual
MRS. KAYLA R KORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
86912 561 AVE, RANDOLPH, NE 68771-7133
(402) 360-0512
Mailing address
86912 561 AVE, RANDOLPH, NE 68771-7133
(402) 360-0512
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1742
NE
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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