Provider Demographics
NPI:1891366373
Name:BATES, CARLY CHAVEZ (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:CHAVEZ
Last Name:BATES
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 WESTLAWN BLVD APT 1137
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-1811
Mailing Address - Country:US
Mailing Address - Phone:615-995-6097
Mailing Address - Fax:
Practice Address - Street 1:1307 WESTLAWN BLVD APT 1137
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-1811
Practice Address - Country:US
Practice Address - Phone:615-995-6097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist