Provider Demographics
NPI:1003553488
Name:TINGEY, KAITLIN (CF-SLP)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:TINGEY
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4555 W 5500 S
Mailing Address - Street 2:
Mailing Address - City:HOOPER
Mailing Address - State:UT
Mailing Address - Zip Code:84315-9520
Mailing Address - Country:US
Mailing Address - Phone:801-940-3426
Mailing Address - Fax:
Practice Address - Street 1:4755 S 3100 W
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-9517
Practice Address - Country:US
Practice Address - Phone:801-940-3426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist