Provider Demographics
NPI:1821496209
Name:PONTE, CAITLIN BROOKE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:BROOKE
Last Name:PONTE
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 1:120 SAINT LOUIS DR
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-6116
Mailing Address - Country:US
Mailing Address - Phone:302-299-5650
Mailing Address - Fax:
Practice Address - Street 1:120 SAINT LOUIS DR
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6116
Practice Address - Country:US
Practice Address - Phone:302-299-5650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07346235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist