Provider Demographics
NPI:1013578616
Name:ZAHN, CARRIE JO (SLP)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:JO
Last Name:ZAHN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 FARM ROAD 1050
Mailing Address - Street 2:
Mailing Address - City:MONETT
Mailing Address - State:MO
Mailing Address - Zip Code:65708-7423
Mailing Address - Country:US
Mailing Address - Phone:417-393-9031
Mailing Address - Fax:
Practice Address - Street 1:601 LEARNING LN
Practice Address - Street 2:
Practice Address - City:MONETT
Practice Address - State:MO
Practice Address - Zip Code:65708-1518
Practice Address - Country:US
Practice Address - Phone:417-235-3411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001012081235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist