Provider Demographics
NPI:1285838169
Name:BRICE, CAITLIN MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CAITLIN
Middle Name:MARIE
Last Name:BRICE
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 1:3928 W CORNELIA AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-5006
Mailing Address - Country:US
Mailing Address - Phone:617-543-2755
Mailing Address - Fax:
Practice Address - Street 1:3928 W CORNELIA AVE FL 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-5006
Practice Address - Country:US
Practice Address - Phone:617-543-2755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist