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NPI Code Detail

MEDICARE: MISS CAITLIN JOY GLASER M.S. CCC-SLP

MEDICARE:  MISS CAITLIN JOY GLASER  M.S. 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
1235Z00000XSpeech-Language Pathologist22857CA

General Provider Information

NPI Number : 1548621139
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS CAITLIN JOY GLASER M.S. CCC-SLP
Provider Business Mailing Address
First Line : 691 VISTA BONITA
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-4555
Country : US
Telephone Number : 201-407-4559
Fax Number :
Provider Business Practice Location Address
First Line : 691 VISTA BONITA
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-4555
Country : US
Telephone Number : 201-407-4559
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2016
Last Update Date : 03/10/2016

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Directions to “ MISS CAITLIN JOY GLASER M.S. CCC-SLP” Practice Location

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