Provider Demographics
NPI:1114267622
Name:HARMS, CARRIE (SLP)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:HARMS
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 1:1860 NE STATE ROUTE D
Mailing Address - Street 2:
Mailing Address - City:WEATHERBY
Mailing Address - State:MO
Mailing Address - Zip Code:64497-9208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1111 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:MO
Practice Address - Zip Code:64429-2005
Practice Address - Country:US
Practice Address - Phone:816-632-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004002765235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist