| Doctor Name: | KAITLIN BAARCK |
| NPI Number: | 1700264876 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. |
| License Number: | 24086 |
| Business Practice Address: | 4 Fairfax Ct Bolingbrook, IL - 604905039 |
| Business Phone Number: | 6309474479 |
| Business Fax Number: | |
| Mailing Address: | 823 Gateway Center Way, SAN DIEGO |
| State: | CA |
| Postal Code: | 921024541 |
| Phone Number: | 6199064623 |
| Fax Number: | 6199064564 |
| NPI Enumeration Date: | 05/11/2015 |
| NPI Last Update Date: | 06/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 24086 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |