Provider Demographics
NPI:1811685878
Name:OLSEN, KAITLYN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:OLSEN
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 1:10849 CHESTNUT HEATH CT
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-6118
Mailing Address - Country:US
Mailing Address - Phone:317-473-2252
Mailing Address - Fax:
Practice Address - Street 1:4940 W 56TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-1408
Practice Address - Country:US
Practice Address - Phone:317-297-3115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist