Provider Demographics
NPI:1902229438
Name:RANKIN, CAROL GLENN (MS, CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:GLENN
Last Name:RANKIN
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:RANKIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC/SLP
Mailing Address - Street 1:1926 HUNTERS CV
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-3386
Mailing Address - Country:US
Mailing Address - Phone:210-275-5591
Mailing Address - Fax:161-280-8124
Practice Address - Street 1:4455 FM 482
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-4991
Practice Address - Country:US
Practice Address - Phone:210-275-5591
Practice Address - Fax:839-608-1411
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15661235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist