Provider Demographics
NPI:1619344306
Name:DOWD, KAITLYN ALYSSA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:KAITLYN
Middle Name:ALYSSA
Last Name:DOWD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-1431
Mailing Address - Country:US
Mailing Address - Phone:302-653-3135
Mailing Address - Fax:302-653-2766
Practice Address - Street 1:22 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1431
Practice Address - Country:US
Practice Address - Phone:302-653-3135
Practice Address - Fax:302-653-2766
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO1-0001473235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist