Provider Demographics
NPI:1841575503
Name:CARR, NANCY LYNN (MS)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LYNN
Last Name:CARR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:NANCY
Other - Middle Name:LYNN
Other - Last Name:GOODMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:COUNTY ROUTE 64
Mailing Address - Street 2:OSWEGO COUNTY BOCES
Mailing Address - City:MEXICO
Mailing Address - State:NY
Mailing Address - Zip Code:13114
Mailing Address - Country:US
Mailing Address - Phone:315-963-4234
Mailing Address - Fax:
Practice Address - Street 1:COUNTY ROUTE 64
Practice Address - Street 2:OSWEGO COUNTY BOCES
Practice Address - City:MEXICO
Practice Address - State:NY
Practice Address - Zip Code:13114
Practice Address - Country:US
Practice Address - Phone:315-963-4234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005202-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist