Provider Demographics
NPI:1508602541
Name:O'BRIEN, CAITLYN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 TIPPERARY DR
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590-2731
Mailing Address - Country:US
Mailing Address - Phone:774-276-2282
Mailing Address - Fax:
Practice Address - Street 1:5 TIPPERARY DR
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:MA
Practice Address - Zip Code:01590-2731
Practice Address - Country:US
Practice Address - Phone:774-276-2282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASLP77252235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist