Provider Demographics
NPI:1346859956
Name:SPAINHOUR, CARLY BREANNA (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:BREANNA
Last Name:SPAINHOUR
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 1:2192 SHIPTONTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-8525
Mailing Address - Country:US
Mailing Address - Phone:336-596-6802
Mailing Address - Fax:
Practice Address - Street 1:2192 SHIPTONTOWN RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-8525
Practice Address - Country:US
Practice Address - Phone:336-596-6802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty