Provider Demographics
NPI:1083243364
Name:ROSS, CAITLIN ANN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ANN
Last Name:ROSS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:ANN
Other - Last Name:TARABOCCHIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5722 MAXIE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-3134
Mailing Address - Country:US
Mailing Address - Phone:432-413-9024
Mailing Address - Fax:
Practice Address - Street 1:5722 MAXIE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-3134
Practice Address - Country:US
Practice Address - Phone:432-413-9024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist