| Doctor Name: | MS. CARRIE HERSTAM STEVENSON |
| NPI Number: | 1023384906 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, CCC-SLP |
| License Number: | SLP-1369 |
| Business Practice Address: | 363 Sunrise Blvd Romney, WV - 267574607 |
| Business Phone Number: | 3048224561 |
| Business Fax Number: | 3048227809 |
| Mailing Address: | 220 Campus Blvd, Suite 200 Attn: Amy Gray WINCHESTER |
| State: | VA |
| Postal Code: | 226012888 |
| Phone Number: | 5405360234 |
| Fax Number: | 5405360235 |
| NPI Enumeration Date: | 03/26/2012 |
| NPI Last Update Date: | 06/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP-1369 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| 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 |