Provider Demographics
NPI:1740580372
Name:LEROW, KAROLIE S (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAROLIE
Middle Name:S
Last Name:LEROW
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 COLONY PLZ
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-1605
Mailing Address - Country:US
Mailing Address - Phone:910-388-2411
Mailing Address - Fax:910-388-2411
Practice Address - Street 1:2112 COLONY PLZ
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-1605
Practice Address - Country:US
Practice Address - Phone:910-388-2411
Practice Address - Fax:910-388-2411
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9257235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist