Provider Demographics
NPI:1639900509
Name:NEAL, CAROLINE MARIE (MS - SLP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:MARIE
Last Name:NEAL
Suffix:
Gender:F
Credentials:MS - SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 ROUSE CT
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-4646
Mailing Address - Country:US
Mailing Address - Phone:636-698-8863
Mailing Address - Fax:
Practice Address - Street 1:207 8TH STREET
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:MO
Practice Address - Zip Code:63389
Practice Address - Country:US
Practice Address - Phone:636-668-8195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024021234235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist