Provider Demographics
NPI:1346534062
Name:DAVIS, CAITLIN MARIE (SLP)
Entity Type:Individual
Prefix:MISS
First Name:CAITLIN
Middle Name:MARIE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 PIERCE CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9697
Mailing Address - Country:US
Mailing Address - Phone:302-379-3456
Mailing Address - Fax:
Practice Address - Street 1:610 DUTCHMANS LN
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3346
Practice Address - Country:US
Practice Address - Phone:410-822-4000
Practice Address - Fax:410-763-9027
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05855235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist