Provider Demographics
NPI:1649774498
Name:SHARP, CAROLYN MULDER (M S CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MULDER
Last Name:SHARP
Suffix:
Gender:F
Credentials:M S CCC-SLP
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:MARIE
Other - Last Name:MULDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5430 BELL TIMBERS ST
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2669
Mailing Address - Country:US
Mailing Address - Phone:832-439-0857
Mailing Address - Fax:281-852-8083
Practice Address - Street 1:5430 BELL TIMBERS ST
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2669
Practice Address - Country:US
Practice Address - Phone:832-439-0857
Practice Address - Fax:281-852-8083
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113818235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist