Provider Demographics
NPI:1508288788
Name:CARSON, CAITLIN ELIZABETH
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ELIZABETH
Last Name:CARSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 SAWDUST RD
Mailing Address - Street 2:STE. 108
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2385
Mailing Address - Country:US
Mailing Address - Phone:281-719-5060
Mailing Address - Fax:281-719-5962
Practice Address - Street 1:525 SAWDUST RD
Practice Address - Street 2:STE. 108
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2385
Practice Address - Country:US
Practice Address - Phone:281-719-5060
Practice Address - Fax:281-719-5962
Is Sole Proprietor?:No
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109750235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist