Provider Demographics
NPI:1235632142
Name:EISENHUT, CAITLIN JO (SLP)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:JO
Last Name:EISENHUT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:JO
Other - Last Name:WALDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:4850 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-1428
Mailing Address - Country:US
Mailing Address - Phone:513-861-0300
Mailing Address - Fax:
Practice Address - Street 1:4850 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-1428
Practice Address - Country:US
Practice Address - Phone:513-861-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-16
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.12324235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist