Provider Demographics
NPI:1538951330
Name:HAVARD, KAYLEE DENISE
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:DENISE
Last Name:HAVARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 SAWMILL LN
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-0656
Mailing Address - Country:US
Mailing Address - Phone:936-465-8454
Mailing Address - Fax:
Practice Address - Street 1:147 SAWMILL LN
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-0656
Practice Address - Country:US
Practice Address - Phone:936-465-8454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123590235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist