Provider Demographics
NPI:1508316274
Name:HARDING, KAITLIN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:HARDING
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 1:1027 BULLTAIL RD
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-8818
Mailing Address - Country:US
Mailing Address - Phone:952-454-1010
Mailing Address - Fax:
Practice Address - Street 1:1027 BULLTAIL RD
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-8818
Practice Address - Country:US
Practice Address - Phone:952-454-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9759235Z00000X
MTSLP-SP-LIC-10725235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist