Provider Demographics
NPI:1972739688
Name:NEWHOUSE, CARLY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:NEWHOUSE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:
Other - Last Name:GOLDRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9433 BEE CAVE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-6135
Mailing Address - Country:US
Mailing Address - Phone:512-306-8007
Mailing Address - Fax:
Practice Address - Street 1:9433 BEE CAVE RD
Practice Address - Street 2:BUILDING 3, SUITE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78733-6135
Practice Address - Country:US
Practice Address - Phone:512-306-8007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019130235Z00000X
TX108688235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist