Provider Demographics
NPI:1578998365
Name:SHAPIRO, CAROL ANNE (MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANNE
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ANNE
Other - Last Name:SHAPIRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, CCC-SLP
Mailing Address - Street 1:1950 BARRETT KNOLL CIR NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-8207
Mailing Address - Country:US
Mailing Address - Phone:706-424-3060
Mailing Address - Fax:
Practice Address - Street 1:1950 BARRETT KNOLL CIR NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-8207
Practice Address - Country:US
Practice Address - Phone:706-424-3060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 21180235Z00000X
GASLP009388235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist