Provider Demographics
NPI:1255218053
Name:KINCADE, KATIE
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:KINCADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17001 EAGLE BEND BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32226-1187
Mailing Address - Country:US
Mailing Address - Phone:904-517-4705
Mailing Address - Fax:
Practice Address - Street 1:17001 EAGLE BEND BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32226-1187
Practice Address - Country:US
Practice Address - Phone:904-517-4705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist