Provider Demographics
NPI:1194383984
Name:LAFRENIERE, KAITLIN PATRICIA (AUD)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:PATRICIA
Last Name:LAFRENIERE
Suffix:
Gender:
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 S SANTA FE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4190
Mailing Address - Country:US
Mailing Address - Phone:785-823-7225
Mailing Address - Fax:785-823-1017
Practice Address - Street 1:520 S SANTA FE AVE STE 200
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4190
Practice Address - Country:US
Practice Address - Phone:785-823-7225
Practice Address - Fax:785-823-1017
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN528542231H00000X, 231H00000X
KS2519231H00000X
WYA-1036237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30005285140001Medicaid