Doctor Name: | CARISSA STEVENS |
NPI Number: | 1952563637 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SP/L |
License Number: | O4-0000255 |
Business Practice Address: | 278 Sorghum Mill Rd Camden Wyoming, DE - 199341935 |
Business Phone Number: | 3026973103 |
Business Fax Number: | 3026974998 |
Mailing Address: | 278 Sorghum Mill Rd, CAMDEN WYOMING |
State: | DE |
Postal Code: | 199341935 |
Phone Number: | 3026973103 |
Fax Number: | 3026974998 |
NPI Enumeration Date: | 06/25/2008 |
NPI Last Update Date: | 06/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | O4-0000255 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | DE |
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 |