Provider Demographics
NPI:1104015619
Name:CHAMBERLIN, CARRIE (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:
Last Name:CHAMBERLIN
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 N ROCKINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-3742
Mailing Address - Country:US
Mailing Address - Phone:716-909-9909
Mailing Address - Fax:
Practice Address - Street 1:241 N ROCKINGHAM WAY
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-3742
Practice Address - Country:US
Practice Address - Phone:716-909-9909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-20
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010713-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist