Provider Demographics
NPI:1407303134
Name:NAGY, CARRIE (MSCCC/SLP-L)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:NAGY
Suffix:
Gender:F
Credentials:MSCCC/SLP-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PA FURNACE
Mailing Address - State:PA
Mailing Address - Zip Code:16865-9712
Mailing Address - Country:US
Mailing Address - Phone:814-280-6153
Mailing Address - Fax:
Practice Address - Street 1:190 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:PA FURNACE
Practice Address - State:PA
Practice Address - Zip Code:16865-9712
Practice Address - Country:US
Practice Address - Phone:814-280-6153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-11
Last Update Date:2016-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006361L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist