Provider Demographics
NPI:1790087377
Name:MCGUFFIE, CARISSA (SLP)
Entity Type:Individual
Prefix:
First Name:CARISSA
Middle Name:
Last Name:MCGUFFIE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2279 VALLEYDALE RD STE 240
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-2110
Mailing Address - Country:US
Mailing Address - Phone:205-739-2066
Mailing Address - Fax:205-719-4022
Practice Address - Street 1:2279 VALLEYDALE RD STE 240
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-2110
Practice Address - Country:US
Practice Address - Phone:205-739-2066
Practice Address - Fax:205-719-4022
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007467235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist