Provider Demographics
NPI:1386189322
Name:FITZPATRICK, CAITLIN MAIRE
Entity Type:Individual
Prefix:MS
First Name:CAITLIN
Middle Name:MAIRE
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PASCOAG
Mailing Address - State:RI
Mailing Address - Zip Code:02859-3522
Mailing Address - Country:US
Mailing Address - Phone:401-568-3091
Mailing Address - Fax:
Practice Address - Street 1:999 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PASCOAG
Practice Address - State:RI
Practice Address - Zip Code:02859-3522
Practice Address - Country:US
Practice Address - Phone:401-568-3091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00359-P235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist