Provider Demographics
NPI:1962630541
Name:MILLER, CAITLIN (MA, CFY-SLP)
Entity Type:Individual
Prefix:MISS
First Name:CAITLIN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 GOLF RD
Mailing Address - Street 2:
Mailing Address - City:TAMAQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18252-5552
Mailing Address - Country:US
Mailing Address - Phone:570-386-2676
Mailing Address - Fax:
Practice Address - Street 1:1 KIRKLAND VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-4797
Practice Address - Country:US
Practice Address - Phone:610-691-4551
Practice Address - Fax:610-814-0689
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PASL009909235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program