Provider Demographics
NPI:1629760798
Name:LOBRANO, CAROLINE AGATHA
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:AGATHA
Last Name:LOBRANO
Suffix:
Gender:F
Credentials:
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 87
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39631-0087
Mailing Address - Country:US
Mailing Address - Phone:601-645-2000
Mailing Address - Fax:
Practice Address - Street 1:178 MS HWY 24
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MS
Practice Address - Zip Code:39631
Practice Address - Country:US
Practice Address - Phone:601-645-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist