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General NPI Number Information
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NPI Number | 1912893827
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Entity Type | Individual
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Provider Name | CAITLIN CONKLIN
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Gender | Female
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1204 LINDEN ST
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City | DALLAS CENTER
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State | IA
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Zip | 50063-1052
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Country | US
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Telephone | 515-729-0024
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Fax |
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Provider Business Mailing Address
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Address Line | 16609 MILL POND DR
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City | URBANDALE
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State | IA
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Zip | 50323-1652
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Country | US
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Telephone | 515-802-0191
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 133183
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License Number State | IA
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