Provider Demographics
NPI:1164764478
Name:HOWARD, CARRIE DALE (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:DALE
Last Name:HOWARD
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 1:305 ROYAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70460
Mailing Address - Country:US
Mailing Address - Phone:985-710-2221
Mailing Address - Fax:
Practice Address - Street 1:305 ROYAL DRIVE
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70460
Practice Address - Country:US
Practice Address - Phone:985-710-2221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4980235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist