Doctor Name: | MS. CARISSA CONNIE SIMONSEN |
NPI Number: | 1306060785 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | SLP1277 |
Business Practice Address: | 58581 865 Rd Allen, NE - 687105084 |
Business Phone Number: | 9287816721 |
Business Fax Number: | |
Mailing Address: | 58581 865 Rd, ALLEN |
State: | NE |
Postal Code: | 687105084 |
Phone Number: | 4023693593 |
Fax Number: | |
NPI Enumeration Date: | 04/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP1277 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
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 |