Doctor Name: | CARLA M PENNINGTON |
NPI Number: | 1093974123 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. CCC-SLP |
License Number: | SLP005317 |
Business Practice Address: | 434 Long Needle Cir Evans, GA - 308095170 |
Business Phone Number: | 7068294848 |
Business Fax Number: | |
Mailing Address: | 434 Long Needle Cir, EVANS |
State: | GA |
Postal Code: | 308095170 |
Phone Number: | 7068294848 |
Fax Number: | |
NPI Enumeration Date: | 06/04/2008 |
NPI Last Update Date: | 06/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP005317 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
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 |