MEDICARE: KAITLYN E WYCHE MA, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	30001660	NC

General Provider Information

NPI Number	:	1295228690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN E WYCHE MA, CCC-SLP

Provider Business Mailing Address
First Line	:	8300 HEALTH PARK STE 325
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-4731
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8300 HEALTH PARK STE 325
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-4731
Country	:	US
Telephone Number	:	919-747-9022
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2018
Last Update Date	:	04/21/2026

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Directions to “ KAITLYN E WYCHE MA, CCC-SLP” Practice Location

Language	Start Address	Practice Location

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