Provider Demographics
NPI:1659477867
Name:NAVE, CARISSA ERIN (MS CCCA)
Entity Type:Individual
Prefix:MRS
First Name:CARISSA
Middle Name:ERIN
Last Name:NAVE
Suffix:
Gender:F
Credentials:MS CCCA
Other - Prefix:MISS
Other - First Name:CARISSA
Other - Middle Name:ERIN
Other - Last Name:DOTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCA
Mailing Address - Street 1:7574 N LA CHOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741
Mailing Address - Country:US
Mailing Address - Phone:520-742-2845
Mailing Address - Fax:520-742-3881
Practice Address - Street 1:7574 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741
Practice Address - Country:US
Practice Address - Phone:520-742-2845
Practice Address - Fax:520-742-3881
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA0062231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist