Provider Demographics
NPI:1053766634
Name:ULRICH, CAITLIN TAYLOR (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:TAYLOR
Last Name:ULRICH
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 N 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-9478
Mailing Address - Country:US
Mailing Address - Phone:405-595-1765
Mailing Address - Fax:
Practice Address - Street 1:2905 N 15TH ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-9478
Practice Address - Country:US
Practice Address - Phone:405-595-1765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist