Doctor Name: | CARISSA TAYLOR |
NPI Number: | 1134542939 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 108539 |
Business Practice Address: | 110 S 12th St Waco, TX - 767011810 |
Business Phone Number: | 2547523451 |
Business Fax Number: | 2547563133 |
Mailing Address: | Po Box 890, WACO |
State: | TX |
Postal Code: | 767030890 |
Phone Number: | 2547523451 |
Fax Number: | 2547563133 |
NPI Enumeration Date: | 01/29/2014 |
NPI Last Update Date: | 01/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 108539 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
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 |