Individual
MRS. CAROLE A KAULITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. CCC-SLP
Contact information
Practice address
3407 NE 169TH AVE, VANCOUVER, WA 98682-8618
(360) 904-6626
Mailing address
3407 NE 169TH AVE, VANCOUVER, WA 98682-8618
(360) 904-6626
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00001258
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7125065
—
WA
Enumeration date
08/13/2007
Last updated
08/13/2007
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