Provider Demographics
NPI:1467091900
Name:HUFSTETLER, KAITLYNN (HAD)
Entity Type:Individual
Prefix:
First Name:KAITLYNN
Middle Name:
Last Name:HUFSTETLER
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 WINDY RIDGE LN SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2404
Mailing Address - Country:US
Mailing Address - Phone:770-820-8397
Mailing Address - Fax:
Practice Address - Street 1:6600 SUGARLOAF PKWY STE 800
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4346
Practice Address - Country:US
Practice Address - Phone:770-476-3005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS001030237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist