Provider Demographics
NPI:1063275907
Name:BENDLIN, KAITLYN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:BENDLIN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 N LOGAN ST APT 104
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3601
Mailing Address - Country:US
Mailing Address - Phone:845-341-7245
Mailing Address - Fax:
Practice Address - Street 1:620 WILCOX ST # 80104
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1730
Practice Address - Country:US
Practice Address - Phone:303-387-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024824235Z00000X
COSLP.0004001235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist