Provider Demographics
NPI:1265134779
Name:CARRILLO, ISABELLE JOY GARCIA
Entity type:Individual
Prefix:
First Name:ISABELLE JOY
Middle Name:GARCIA
Last Name:CARRILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 3RD ST NW APT 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1990
Mailing Address - Country:US
Mailing Address - Phone:201-937-1494
Mailing Address - Fax:
Practice Address - Street 1:412 1ST ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-1804
Practice Address - Country:US
Practice Address - Phone:202-470-4185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist