Provider Demographics
NPI:1538544481
Name:KISHORE, CAITLIN (AUD)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:KISHORE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CAILTIN
Other - Middle Name:
Other - Last Name:CANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:171 GRANDVIEW AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2517
Mailing Address - Country:US
Mailing Address - Phone:203-578-4630
Mailing Address - Fax:
Practice Address - Street 1:171 GRANDVIEW AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2517
Practice Address - Country:US
Practice Address - Phone:203-578-4630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT568231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist