Provider Demographics
NPI:1255835625
Name:BYRON, CAITLIN K (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:K
Last Name:BYRON
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 1:125 S BLAKELY ST
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-2201
Mailing Address - Country:US
Mailing Address - Phone:570-862-0793
Mailing Address - Fax:
Practice Address - Street 1:125 S BLAKELY ST
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-2201
Practice Address - Country:US
Practice Address - Phone:570-862-0793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013248235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist