Provider Demographics
NPI:1114246097
Name:MCCAREY-DODDS, CAPRICE (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:CAPRICE
Middle Name:
Last Name:MCCAREY-DODDS
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 1:109 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SWEENY
Mailing Address - State:TX
Mailing Address - Zip Code:77480-3005
Mailing Address - Country:US
Mailing Address - Phone:979-243-9100
Mailing Address - Fax:877-335-8374
Practice Address - Street 1:109 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SWEENY
Practice Address - State:TX
Practice Address - Zip Code:77480-3005
Practice Address - Country:US
Practice Address - Phone:979-548-3562
Practice Address - Fax:877-335-8374
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19765235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX219316101Medicaid