Provider Demographics
NPI:1598115164
Name:WILEY, CAITLIN EMMA (MCD CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:EMMA
Last Name:WILEY
Suffix:
Gender:F
Credentials:MCD CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7252 LAKESHORE DR STE I
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-2433
Mailing Address - Country:US
Mailing Address - Phone:504-323-3450
Mailing Address - Fax:
Practice Address - Street 1:7252 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-2433
Practice Address - Country:US
Practice Address - Phone:504-323-3450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6000235Z00000X
LA7886235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist