Provider Demographics
NPI:1871110411
Name:DOLPHIN, KAYLEIGH (MS, LAT, ATC, CES)
Entity type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:
Last Name:DOLPHIN
Suffix:
Gender:F
Credentials:MS, LAT, ATC, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 SPRINGBROOK AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-8520
Mailing Address - Country:US
Mailing Address - Phone:919-535-8461
Mailing Address - Fax:919-535-8459
Practice Address - Street 1:166 SPRINGBROOK AVE STE 201
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-8520
Practice Address - Country:US
Practice Address - Phone:919-535-8461
Practice Address - Fax:919-535-8459
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-29392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer