Provider Demographics
NPI:1932657897
Name:O'ROURKE, KAITLYN S (AUD, F-AAA, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:S
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:AUD, F-AAA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 YONKERS AVE
Mailing Address - Street 2:UNIT 2
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-2666
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:622 YONKERS AVE
Practice Address - Street 2:UNIT 2
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-2666
Practice Address - Country:US
Practice Address - Phone:914-968-7555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002655231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist