Doctor Name: | JUDY ANN CARROLL |
NPI Number: | 1134522543 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | 13567 |
Business Practice Address: | 331 E Park St Weiser, ID - 836722053 |
Business Phone Number: | 2085492416 |
Business Fax Number: | |
Mailing Address: | 331 E Park St, WEISER |
State: | ID |
Postal Code: | 836722053 |
Phone Number: | 2085492416 |
Fax Number: | |
NPI Enumeration Date: | 09/30/2014 |
NPI Last Update Date: | 09/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 13567 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OR |
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 |