Provider Demographics
NPI:1528193661
Name:BATES, CARRIE ASH (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ASH
Last Name:BATES
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6711 BLUE SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-1964
Mailing Address - Country:US
Mailing Address - Phone:812-490-5626
Mailing Address - Fax:
Practice Address - Street 1:150 N ROSENBERGER AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-6503
Practice Address - Country:US
Practice Address - Phone:812-424-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist