Provider Demographics
NPI:1275265910
Name:MCCARTY, SHARLA (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHARLA
Middle Name:
Last Name:MCCARTY
Suffix:
Gender:F
Credentials: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 1:849 WAGGONER TAP RD
Mailing Address - Street 2:
Mailing Address - City:TULLOS
Mailing Address - State:LA
Mailing Address - Zip Code:71479-6085
Mailing Address - Country:US
Mailing Address - Phone:318-316-2087
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 90
Practice Address - Street 2:
Practice Address - City:JENA
Practice Address - State:LA
Practice Address - Zip Code:71342-0090
Practice Address - Country:US
Practice Address - Phone:318-992-5971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4608235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist