Provider Demographics
NPI:1407239528
Name:EDDINS, KATIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:EDDINS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:81 S MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2400
Mailing Address - Country:US
Mailing Address - Phone:860-385-4327
Mailing Address - Fax:
Practice Address - Street 1:81 S MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2400
Practice Address - Country:US
Practice Address - Phone:860-385-4327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004510235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist