Provider Demographics
NPI:1518144096
Name:CASPER, MARY-ELLEN OWEN (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:MARY-ELLEN
Middle Name:OWEN
Last Name:CASPER
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N 15TH ST STE 11
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-4500
Mailing Address - Country:US
Mailing Address - Phone:903-872-6333
Mailing Address - Fax:903-872-3310
Practice Address - Street 1:200 N 15TH ST STE 11
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-4500
Practice Address - Country:US
Practice Address - Phone:903-872-6333
Practice Address - Fax:903-872-3310
Is Sole Proprietor?:No
Enumeration Date:2008-01-27
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50405231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist