Provider Demographics
NPI:1538299227
Name:HEWITT, CARRIE (MS-CCC,SLP)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:
Last Name:HEWITT
Suffix:
Gender:F
Credentials:MS-CCC,SLP
Other - Prefix:MR
Other - First Name:CARRIE
Other - Middle Name:HEWITT
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS-CCC,SLP
Mailing Address - Street 1:955 NEW WATERFORD DR
Mailing Address - Street 2:#104
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-8300
Mailing Address - Country:US
Mailing Address - Phone:239-348-0204
Mailing Address - Fax:
Practice Address - Street 1:955 NEW WATERFORD DR
Practice Address - Street 2:#104
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-8300
Practice Address - Country:US
Practice Address - Phone:239-348-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8093235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist