Provider Demographics
NPI:1114408382
Name:CARLTON, NAYTRICE PORSCHAE
Entity Type:Individual
Prefix:
First Name:NAYTRICE
Middle Name:PORSCHAE
Last Name:CARLTON
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 1:25867 W ST CATHERINE AVE
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-2125
Mailing Address - Country:US
Mailing Address - Phone:234-716-8972
Mailing Address - Fax:
Practice Address - Street 1:25867 W ST CATHERINE AVE
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-2125
Practice Address - Country:US
Practice Address - Phone:234-716-8972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist