Provider Demographics
NPI:1477892388
Name:FJELD, CAROL ELLEN (CCC-SP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ELLEN
Last Name:FJELD
Suffix:
Gender:F
Credentials:CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:294 WHEELER ROAD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:VT
Mailing Address - Zip Code:05733
Mailing Address - Country:US
Mailing Address - Phone:802-247-6534
Mailing Address - Fax:
Practice Address - Street 1:294 WHEELER RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:VT
Practice Address - Zip Code:05733-8928
Practice Address - Country:US
Practice Address - Phone:802-247-6534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist