Provider Demographics
NPI:1619394319
Name:CEARLEY, CASIE MCKAMIE (MS)
Entity Type:Individual
Prefix:MRS
First Name:CASIE
Middle Name:MCKAMIE
Last Name:CEARLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:CASIE
Other - Middle Name:RENEE
Other - Last Name:MCKAMIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1250 WEST SAM HOUSTON PKWY SOUTH
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042
Mailing Address - Country:US
Mailing Address - Phone:713-783-8181
Mailing Address - Fax:
Practice Address - Street 1:1250 W SAM HOUSTON PKWY S
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-1941
Practice Address - Country:US
Practice Address - Phone:713-783-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105888235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist