Provider Demographics
NPI:1235449323
Name:EATON, CAROLYN SANDS (MED, MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:SANDS
Last Name:EATON
Suffix:
Gender:F
Credentials:MED, MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HEMLOCK POINT RD
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04473-3056
Mailing Address - Country:US
Mailing Address - Phone:207-942-8076
Mailing Address - Fax:
Practice Address - Street 1:13 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:ME
Practice Address - Zip Code:04461-3300
Practice Address - Country:US
Practice Address - Phone:207-827-2252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1174235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist