Provider Demographics
NPI:1861228991
Name:KINDER, KAILIE (SLP-A)
Entity type:Individual
Prefix:
First Name:KAILIE
Middle Name:
Last Name:KINDER
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 HIGHWAY YY
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MO
Mailing Address - Zip Code:65560-9681
Mailing Address - Country:US
Mailing Address - Phone:573-466-2713
Mailing Address - Fax:
Practice Address - Street 1:281 HIGHWAY YY
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MO
Practice Address - Zip Code:65560-9681
Practice Address - Country:US
Practice Address - Phone:573-466-2713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230324032355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant