Provider Demographics
NPI:1851765077
Name:CARVER, KATHRYN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:CARVER
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 1:1000 SIBLEY RD
Mailing Address - Street 2:
Mailing Address - City:EAST MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05651-4108
Mailing Address - Country:US
Mailing Address - Phone:541-408-0084
Mailing Address - Fax:
Practice Address - Street 1:101 COLLEGE PKWY
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-3013
Practice Address - Country:US
Practice Address - Phone:802-847-1988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-27
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT144.0114844235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist