Provider Demographics
NPI:1659625812
Name:ORR, COLBY CAITLIN (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:COLBY
Middle Name:CAITLIN
Last Name:ORR
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 1:728 CARPENTER RDG
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-9069
Mailing Address - Country:US
Mailing Address - Phone:419-461-6902
Mailing Address - Fax:
Practice Address - Street 1:728 CARPENTER RDG
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-9069
Practice Address - Country:US
Practice Address - Phone:419-461-6902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.10647235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist