MEDICARE: MISS CAITLIN EILEEN WILTERINK MS, 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	7101005023	MI

General Provider Information

NPI Number	:	1851757637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CAITLIN EILEEN WILTERINK MS, CCC-SLP

Provider Business Mailing Address
First Line	:	3152 PEREGRINE DR NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-9723
Country	:	US
Telephone Number	:	616-643-0833
Fax Number	:

Provider Business Practice Location Address
First Line	:	3152 PEREGRINE DR NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-9723
Country	:	US
Telephone Number	:	616-643-0833
Fax Number	:

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

Provider Enumeration Date	:	01/08/2016
Last Update Date	:	07/24/2025

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Directions to “ MISS CAITLIN EILEEN WILTERINK MS, CCC-SLP” Practice Location

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