Provider Demographics
NPI:1740891035
Name:HILL, KAITLIN TATE (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:TATE
Last Name:HILL
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MATTIE LENE DR
Mailing Address - Street 2:
Mailing Address - City:WARD
Mailing Address - State:AR
Mailing Address - Zip Code:72176-8752
Mailing Address - Country:US
Mailing Address - Phone:870-844-0625
Mailing Address - Fax:
Practice Address - Street 1:21 MATTIE LENE DR
Practice Address - Street 2:
Practice Address - City:WARD
Practice Address - State:AR
Practice Address - Zip Code:72176-8752
Practice Address - Country:US
Practice Address - Phone:870-844-0625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist