Provider Demographics
NPI:1699550186
Name:KERRIGAN, CAROLINE M (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:M
Last Name:KERRIGAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 STURDY ST
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3521
Mailing Address - Country:US
Mailing Address - Phone:732-664-4045
Mailing Address - Fax:
Practice Address - Street 1:111 GALWAY PL
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3640
Practice Address - Country:US
Practice Address - Phone:201-837-8371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01180900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist