Provider Demographics
NPI:1376837302
Name:WINCHELL, CAROLYN FRANCES (MS)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:FRANCES
Last Name:WINCHELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21628 GOLDEN STAR BLVD
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-8902
Mailing Address - Country:US
Mailing Address - Phone:661-823-8101
Mailing Address - Fax:
Practice Address - Street 1:21628 GOLDEN STAR BLVD
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-8902
Practice Address - Country:US
Practice Address - Phone:661-823-8101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 18875235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASP 18875OtherSPEECH/LANGUAGE PATHOLOGIST