Healthcare Provider Details

I. General information

NPI: 1922919752
Provider Name (Legal Business Name): CAITLIN LANDRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 MOHAWK ST
DANVERS MA
01923-1149
US

IV. Provider business mailing address

26 MOHAWK ST
DANVERS MA
01923-1149
US

V. Phone/Fax

Practice location:
  • Phone: 508-443-1718
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: