Provider Demographics
NPI:1922993344
Name:MOTTER, KAYLA MAE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MAE
Last Name:MOTTER
Suffix:
Gender:X
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6455 N OAK RD
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-9306
Mailing Address - Country:US
Mailing Address - Phone:810-296-8493
Mailing Address - Fax:
Practice Address - Street 1:900 CENTER AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-6189
Practice Address - Country:US
Practice Address - Phone:989-778-2098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101007563235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist