Healthcare Provider Details

I. General information

NPI: 1861250367
Provider Name (Legal Business Name): CAITLYN DUCKWORTH CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAITLYN MARTIN

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CENTER ST STE B
MOBILE AL
36604-1541
US

IV. Provider business mailing address

PO BOX 746450
ATLANTA GA
30374-6450
US

V. Phone/Fax

Practice location:
  • Phone: 251-415-1670
  • Fax: 251-415-1671
Mailing address:
  • Phone: 866-401-3057
  • Fax: 318-868-6430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5547
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: