Provider Demographics
NPI:1760099469
Name:CAZALAS, KAITLYN HUDNALL (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:HUDNALL
Last Name:CAZALAS
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 1:26105 BRICKHILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-4948
Mailing Address - Country:US
Mailing Address - Phone:281-881-9327
Mailing Address - Fax:
Practice Address - Street 1:8505 TECHNOLOGY FOREST PL
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77381-1000
Practice Address - Country:US
Practice Address - Phone:713-903-2271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-26
Last Update Date:2020-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115701235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty