Provider Demographics
NPI:1457547556
Name:CAREY, WANDA L (CDS)
Entity Type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:L
Last Name:CAREY
Suffix:
Gender:F
Credentials:CDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29302 BIERI RD
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA
Mailing Address - State:MO
Mailing Address - Zip Code:65018-3320
Mailing Address - Country:US
Mailing Address - Phone:573-796-8253
Mailing Address - Fax:573-796-3921
Practice Address - Street 1:29302 BIERI RD
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:MO
Practice Address - Zip Code:65018-3320
Practice Address - Country:US
Practice Address - Phone:573-796-8253
Practice Address - Fax:573-796-3921
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health