| Doctor Name: | CARRIE LYNN VITKO |
| NPI Number: | 1285679928 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CCC-SLP |
| License Number: | 3461 |
| Business Practice Address: | 400 E. 2nd St. Centennial Hall Bloomsburg, PA - 178151301 |
| Business Phone Number: | 5703895380 |
| Business Fax Number: | 5703895022 |
| Mailing Address: | Po Box 1388, KINGSTON |
| State: | PA |
| Postal Code: | 187040388 |
| Phone Number: | 5702888881 |
| Fax Number: | 5702888065 |
| NPI Enumeration Date: | 06/17/2006 |
| NPI Last Update Date: | 06/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 3461 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| 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 |