Most Relevant Information
Provider Data
| NPI Number: | 1003490665 |
| Provider Name: | KAILA C BARDOO M.S., CCC-SLP, TSSLD |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/10/2021 |
| Last Updated: | 09/24/2023 |
Provider Practice Location
624 HAWKINS AVE
RONKONKOMA
NY
117792375
Practice Location Phone/Fax
| Phone: | 6312403579 |
| Fax: |
Provider Mailing Location
1357 PETERS BLVD
BAY SHORE
NY
117064848
Provider Mailing Phone/Fax
| Phone: | 5164736718 |
| Fax: |