Provider Demographics
NPI:1821168170
Name:PEOPLES, CAROL (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:PEOPLES
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SUMRELL ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8664
Mailing Address - Country:US
Mailing Address - Phone:252-531-0633
Mailing Address - Fax:
Practice Address - Street 1:201 SUMRELL ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-8664
Practice Address - Country:US
Practice Address - Phone:252-531-0633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCASHA 01061603235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC83671OtherBCBS NC