Provider Demographics
NPI:1972233799
Name:HASKINS, CAROLINE E (MS-CCC, SLP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:E
Last Name:HASKINS
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 1:4011 BENBROOK HWY STE C
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-7800
Mailing Address - Country:US
Mailing Address - Phone:817-386-5500
Mailing Address - Fax:817-367-9076
Practice Address - Street 1:4011 BENBROOK HWY STE C
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-7800
Practice Address - Country:US
Practice Address - Phone:817-386-5500
Practice Address - Fax:817-367-9076
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116476235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist