Provider Demographics
NPI:1891310322
Name:ALSHESKIE, KAITLYN MORGAN
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:MORGAN
Last Name:ALSHESKIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 TOWN BLVD NE UNIT 1411
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3144
Mailing Address - Country:US
Mailing Address - Phone:586-873-6476
Mailing Address - Fax:
Practice Address - Street 1:6505 SHILOH RD STE 100
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-1645
Practice Address - Country:US
Practice Address - Phone:678-648-7479
Practice Address - Fax:678-882-7040
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP011572235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist