Provider Demographics
NPI:1194019604
Name:CARTER, APRIL SHANNELLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:SHANNELLE
Last Name:CARTER
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 1:7460 CHADS CIR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-5703
Mailing Address - Country:US
Mailing Address - Phone:404-324-8530
Mailing Address - Fax:678-489-3209
Practice Address - Street 1:6555 PROFESSIONAL PL STE A
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-4903
Practice Address - Country:US
Practice Address - Phone:770-997-7890
Practice Address - Fax:770-997-7894
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007004235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist