National Provider Identifier
Kaitlyn Rose Agen
Kaitlyn Rose Agen is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Eden, NY and a listed phone number of (716) 228-3114.
Profile Overview
- NPI
- 1487176152
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- July 13, 2017
- Last Updated
- May 01, 2019
Practice Location
- 2957 Schoolview Road
- Eden, NY 14057
Phone: (716) 228-3114
Specialties
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1487176152
- Entity Type
- Individual
- Last Name
- Agen
- First Name
- Kaitlyn
- Middle Name
- Rose
- Provider Other Last Name
- Stayzer
- Provider Other First Name
- Kaitlyn
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 2957 Schoolview Road
- Mailing City
- Eden
- Mailing State
- NY
- Mailing ZIP Code
- 14057
- Mailing Country
- US
- Mailing Phone
- (716) 228-3114
- Practice Street Address
- 2957 Schoolview Road
- Practice City
- Eden
- Practice State
- NY
- Practice ZIP Code
- 14057
- Practice Country
- US
- Practice Phone
- (716) 228-3114
- Enumeration Date
- July 13, 2017
- Last Updated
- May 01, 2019
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X)