Provider Demographics
NPI:1275840746
Name:WEATHERSPOON, KARLA KAY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KARLA
Middle Name:KAY
Last Name:WEATHERSPOON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3816 N ELM ST STE E
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2776
Mailing Address - Country:US
Mailing Address - Phone:336-370-4070
Mailing Address - Fax:336-370-9008
Practice Address - Street 1:3816 N ELM ST STE E
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2776
Practice Address - Country:US
Practice Address - Phone:336-370-4070
Practice Address - Fax:336-370-9008
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9050235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist