Provider Demographics
NPI:1558101642
Name:CAREY, KAITLYN BRYN
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:BRYN
Last Name:CAREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 MEETINGHOUSE RD APT S20
Mailing Address - Street 2:
Mailing Address - City:UPPER CHICHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19061-2985
Mailing Address - Country:US
Mailing Address - Phone:727-310-9363
Mailing Address - Fax:
Practice Address - Street 1:2220 SHIPLEY RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-2306
Practice Address - Country:US
Practice Address - Phone:302-479-1621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO1-0012404235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist