Doctor Name: | CARLIE BOULDIN |
NPI Number: | 1003286741 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | 3847 |
Business Practice Address: | 500 Spanish Fort Blvd Spanish Fort, AL - 365275018 |
Business Phone Number: | 2516268526 |
Business Fax Number: | 2516264878 |
Mailing Address: | 245 Cahaba Valley Pkwy, Ste. 200 PELHAM |
State: | AL |
Postal Code: | 351242216 |
Phone Number: | 2059426820 |
Fax Number: | 2053147222 |
NPI Enumeration Date: | 10/06/2015 |
NPI Last Update Date: | 10/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3847 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
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 |