Provider Demographics
NPI:1891133666
Name:WELLS, CAITLIN EILEEN (MS CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:EILEEN
Last Name:WELLS
Suffix:
Gender:F
Credentials:MS CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 WEAVER ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-4304
Mailing Address - Country:US
Mailing Address - Phone:201-787-6682
Mailing Address - Fax:
Practice Address - Street 1:187 WEAVER ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-4304
Practice Address - Country:US
Practice Address - Phone:201-787-6682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4960235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist