Provider Demographics
NPI:1942040597
Name:DALEY, KYLA JEAN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KYLA
Middle Name:JEAN
Last Name:DALEY
Suffix:
Gender:F
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 1:1414 N ASHLAND AVE APT 2F
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-2223
Mailing Address - Country:US
Mailing Address - Phone:630-687-2278
Mailing Address - Fax:
Practice Address - Street 1:1414 N ASHLAND AVE APT 2F
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2223
Practice Address - Country:US
Practice Address - Phone:630-687-2278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.017716235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist