Provider Demographics
NPI:1700282134
Name:CAITLIN M. INGRAHAM, M.S., CCC-SLP
Entity Type:Organization
Organization Name:CAITLIN M. INGRAHAM, M.S., CCC-SLP
Other - Org Name:SMALL TALK 4 KIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:INGRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:203-990-3392
Mailing Address - Street 1:132 E PUTNAM AVE STE 14
Mailing Address - Street 2:
Mailing Address - City:COS COB
Mailing Address - State:CT
Mailing Address - Zip Code:06807-2753
Mailing Address - Country:US
Mailing Address - Phone:203-990-3392
Mailing Address - Fax:203-990-3393
Practice Address - Street 1:132 E PUTNAM AVE STE 14
Practice Address - Street 2:
Practice Address - City:COS COB
Practice Address - State:CT
Practice Address - Zip Code:06807-2753
Practice Address - Country:US
Practice Address - Phone:203-990-3392
Practice Address - Fax:203-990-3393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-12
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004133235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty