Provider Demographics
NPI:1720452089
Name:GEDDES, CARLY ANN-BYERS (CF-SLP)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:ANN-BYERS
Last Name:GEDDES
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:ANN
Other - Last Name:BYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1503 MICHAELS RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4822
Mailing Address - Country:US
Mailing Address - Phone:804-288-6245
Mailing Address - Fax:
Practice Address - Street 1:1503 MICHAELS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4822
Practice Address - Country:US
Practice Address - Phone:804-288-6245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007848235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist