Provider Demographics
NPI:1922378405
Name:ST. CATHERINE, CARLA (SLP-A)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:ST. CATHERINE
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7128 W WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85043-7808
Mailing Address - Country:US
Mailing Address - Phone:623-826-3801
Mailing Address - Fax:
Practice Address - Street 1:7128 W WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85043-7808
Practice Address - Country:US
Practice Address - Phone:623-826-3801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ72542355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant