Provider Demographics
NPI:1417348913
Name:CARPENTER, CAROL W (SLP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:W
Last Name:CARPENTER
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 1:513 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19067-2210
Mailing Address - Country:US
Mailing Address - Phone:267-243-1951
Mailing Address - Fax:
Practice Address - Street 1:513 HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067-2210
Practice Address - Country:US
Practice Address - Phone:267-243-1951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL001329L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist