Provider Demographics
NPI:1962171884
Name:RACZ, CAITLYN MARIE
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:MARIE
Last Name:RACZ
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 1:3441 S BEVERLY PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-3870
Mailing Address - Country:US
Mailing Address - Phone:480-236-7583
Mailing Address - Fax:
Practice Address - Street 1:1 W ELLIOT RD STE 109
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1310
Practice Address - Country:US
Practice Address - Phone:480-608-9898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant