Provider Demographics
NPI:1467027912
Name:BRZECZKOWSKI, KAITLYN M (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:M
Last Name:BRZECZKOWSKI
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11235 BEECHNUT LN
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-1496
Mailing Address - Country:US
Mailing Address - Phone:440-226-0759
Mailing Address - Fax:
Practice Address - Street 1:34050 GLEN DR
Practice Address - Street 2:
Practice Address - City:EASTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44095-2604
Practice Address - Country:US
Practice Address - Phone:440-283-2707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist