Provider Demographics
NPI:1003544545
Name:ARRAIAL, KAITLYN SUSAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:SUSAN
Last Name:ARRAIAL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:KAITLYN
Other - Middle Name:SUSAN
Other - Last Name:ARRAIAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:38 OAKLAWN AVE APT 312
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-9367
Mailing Address - Country:US
Mailing Address - Phone:401-262-7265
Mailing Address - Fax:
Practice Address - Street 1:1139 MAIN AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1940
Practice Address - Country:US
Practice Address - Phone:401-262-7265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP01636235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist