Provider Demographics
NPI:1013577402
Name:BRYAN, CAITLIN MARIE (AUD)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MARIE
Last Name:BRYAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:MARIE
Other - Last Name:AUST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6500 29TH ST STE 106
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-8386
Mailing Address - Country:US
Mailing Address - Phone:970-330-5555
Mailing Address - Fax:970-584-1055
Practice Address - Street 1:2001 S SHIELDS ST STE 101
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1827
Practice Address - Country:US
Practice Address - Phone:970-493-5334
Practice Address - Fax:970-493-3727
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5166231H00000X
CO0001122231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist