Healthcare Provider Details

I. General information

NPI: 1689588527
Provider Name (Legal Business Name): CAITLIN VINCENT M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15760 190TH AVE
BIG RAPIDS MI
49307-9096
US

IV. Provider business mailing address

7659 N WOODBRIDGE AVE # 215
BROHMAN MI
49312-5129
US

V. Phone/Fax

Practice location:
  • Phone: 231-414-0566
  • Fax:
Mailing address:
  • Phone: 231-414-0566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101008069
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: