Provider Demographics
NPI:1669435400
Name:SOMMERS, CAROL (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:SOMMERS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4994 MUSHROOM ROCK CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-2904
Mailing Address - Country:US
Mailing Address - Phone:719-351-6263
Mailing Address - Fax:
Practice Address - Street 1:4994 MUSHROOM ROCK CT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924-2904
Practice Address - Country:US
Practice Address - Phone:719-351-6263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2023-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COASHA #01103859235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist