Provider Demographics
NPI:1851845325
Name:WADE, CARA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:WADE
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 1:2824 BIG HORN AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-2050
Mailing Address - Country:US
Mailing Address - Phone:308-380-9674
Mailing Address - Fax:
Practice Address - Street 1:1604 SWEETWATER AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-2668
Practice Address - Country:US
Practice Address - Phone:308-762-4331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist