Provider Demographics
NPI:1033602800
Name:WEBB, CAROLYN STILTNER
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:STILTNER
Last Name:WEBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1018
Mailing Address - Street 2:
Mailing Address - City:VANSANT
Mailing Address - State:VA
Mailing Address - Zip Code:24656-1018
Mailing Address - Country:US
Mailing Address - Phone:276-597-2377
Mailing Address - Fax:
Practice Address - Street 1:6911 HURLEY RD
Practice Address - Street 2:
Practice Address - City:HURLEY
Practice Address - State:VA
Practice Address - Zip Code:24620-9506
Practice Address - Country:US
Practice Address - Phone:276-566-8523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No302F00000XManaged Care OrganizationsExclusive Provider Organization