Provider Demographics
NPI:1760242580
Name:TRUITT, KAITLIN RACHELLE RAMSEY (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:RACHELLE RAMSEY
Last Name:TRUITT
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 1:2570 LAKE RIDGE RD APT 9209
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4989
Mailing Address - Country:US
Mailing Address - Phone:913-207-9188
Mailing Address - Fax:
Practice Address - Street 1:721 VILLAGE PARK LN
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-2394
Practice Address - Country:US
Practice Address - Phone:469-219-2290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118615235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist