Provider Demographics
NPI:1578884730
Name:CAREY, MATTHEW (CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:CAREY
Suffix:
Gender:M
Credentials: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:PO BOX 2418
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72303-2418
Mailing Address - Country:US
Mailing Address - Phone:870-792-7868
Mailing Address - Fax:870-792-7868
Practice Address - Street 1:1605 2ND ST
Practice Address - Street 2:
Practice Address - City:EARLE
Practice Address - State:AR
Practice Address - Zip Code:72331-1634
Practice Address - Country:US
Practice Address - Phone:870-792-7868
Practice Address - Fax:870-792-7868
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP8191235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist