Provider Demographics
NPI:1255854774
Name:CHEN, KITAYA (CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KITAYA
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9625 ASH CT
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-6052
Mailing Address - Country:US
Mailing Address - Phone:216-798-6116
Mailing Address - Fax:
Practice Address - Street 1:400 MAPLE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45216-2128
Practice Address - Country:US
Practice Address - Phone:513-482-7115
Practice Address - Fax:513-641-5502
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2017251235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist