Provider Demographics
NPI:1346432762
Name:CAIN, CHARLOTTE ANN (SLP)
Entity Type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:ANN
Last Name:CAIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 SWEETWATER RIM
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-5691
Mailing Address - Country:US
Mailing Address - Phone:888-735-9403
Mailing Address - Fax:888-735-9403
Practice Address - Street 1:208 SWEETWATER RIM
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-5691
Practice Address - Country:US
Practice Address - Phone:888-735-9403
Practice Address - Fax:888-735-9403
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA748235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA748OtherLA.BOARD OF EXAMINERS