Individual
KAYLA HARRETOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1415 LINCOLNWAY W STE M, OSCEOLA, IN 46561-2061
(574) 675-7767
(574) 675-9344
Mailing address
19601 PASADENA AVE, SOUTH BEND, IN 46614-5611
(219) 742-5294
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14477703
IN
Other
Enumeration date
06/09/2025
Last updated
06/15/2025
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