Provider Demographics
NPI:1275903726
Name:STANLEY, CARRIE NICHOLE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:NICHOLE
Last Name:STANLEY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:NICHOLE
Other - Last Name:HARPENAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2035 BRATTON PLACE DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1328
Mailing Address - Country:US
Mailing Address - Phone:812-219-8405
Mailing Address - Fax:
Practice Address - Street 1:2035 BRATTON PLACE DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-1328
Practice Address - Country:US
Practice Address - Phone:812-219-8405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000005650235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist