Provider Demographics
NPI:1205675220
Name:CARPENTER, SIERRA DAWN (AUD)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:DAWN
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 STATE FARM RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4862
Mailing Address - Country:US
Mailing Address - Phone:828-264-4545
Mailing Address - Fax:
Practice Address - Street 1:870 STATE FARM RD STE 101
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4862
Practice Address - Country:US
Practice Address - Phone:828-264-4545
Practice Address - Fax:828-263-5698
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30002838231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist