Provider Demographics
NPI:1235997859
Name:KILBAN, KAITLYN ROSE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:KAITLYN
Middle Name:ROSE
Last Name:KILBAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 JUDITH RD
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191-1751
Mailing Address - Country:US
Mailing Address - Phone:781-733-0921
Mailing Address - Fax:
Practice Address - Street 1:150 WOOD RD
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2504
Practice Address - Country:US
Practice Address - Phone:888-828-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASLP100445235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist