Provider Demographics
NPI:1386000289
Name:LEBARON, CAROL (SLP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:LEBARON
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 1:4258 HIGHWAY 49 S
Mailing Address - Street 2:554
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-0345
Mailing Address - Country:US
Mailing Address - Phone:888-559-2818
Mailing Address - Fax:704-731-0975
Practice Address - Street 1:4250 MAIN ST
Practice Address - Street 2:211
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-7469
Practice Address - Country:US
Practice Address - Phone:888-559-2818
Practice Address - Fax:704-731-0975
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1605151235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist