Provider Demographics
NPI:1043416589
Name:MAYER, CAROL A (MS CCCSLP COM)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:A
Last Name:MAYER
Suffix:
Gender:F
Credentials:MS CCCSLP COM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SPINNING WHEEL RD
Mailing Address - Street 2:# 419
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521
Mailing Address - Country:US
Mailing Address - Phone:630-309-5083
Mailing Address - Fax:630-789-8346
Practice Address - Street 1:15 SPINNING WHEEL RD
Practice Address - Street 2:# 419
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521
Practice Address - Country:US
Practice Address - Phone:630-309-5083
Practice Address - Fax:630-789-8346
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
14600117235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist