Healthcare Provider Details

I. General information

NPI: 1770267213
Provider Name (Legal Business Name): KAITLIN CUMMINGS MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 W ASH ST
JUNCTION CITY KS
66441-3332
US

IV. Provider business mailing address

3317 LYNBROOK DR
PLANO TX
75075-7728
US

V. Phone/Fax

Practice location:
  • Phone: 785-762-2162
  • Fax:
Mailing address:
  • Phone: 254-291-1226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: