Provider Demographics
NPI:1619692662
Name:CLAUSEN, CARRIE LEE (SLPA)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:LEE
Last Name:CLAUSEN
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 S 194TH LN
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-6007
Mailing Address - Country:US
Mailing Address - Phone:623-256-7459
Mailing Address - Fax:
Practice Address - Street 1:463 S 194TH LN
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-6007
Practice Address - Country:US
Practice Address - Phone:623-256-7459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA137052355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant