Provider Demographics
NPI:1396316360
Name:MAUSTELLER, KAITLIN JANE (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:KAITLIN
Middle Name:JANE
Last Name:MAUSTELLER
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 S GORDNER CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:UNITYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17774-9330
Mailing Address - Country:US
Mailing Address - Phone:570-772-3295
Mailing Address - Fax:
Practice Address - Street 1:132 ABIGAIL LN
Practice Address - Street 2:
Practice Address - City:PORT MATILDA
Practice Address - State:PA
Practice Address - Zip Code:16870-7153
Practice Address - Country:US
Practice Address - Phone:800-230-4565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAA0003117490231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist