Provider Demographics
NPI:1245614684
Name:DENNIS, CAITLIN CONWAY (SLP)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:CONWAY
Last Name:DENNIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:ELIZABETH
Other - Last Name:CONWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8740 ORION PL STE 110
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-4063
Mailing Address - Country:US
Mailing Address - Phone:614-734-7777
Mailing Address - Fax:
Practice Address - Street 1:7840 GRAPHICS WAY
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-8002
Practice Address - Country:US
Practice Address - Phone:740-657-4050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI60567476235Z00000X
OHSP.12875235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist