Provider Demographics
NPI:1770771032
Name:TINDALE, CAROLINE ROPER (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:ROPER
Last Name:TINDALE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3776 FORSYTHE WAY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-3049
Mailing Address - Country:US
Mailing Address - Phone:850-668-6315
Mailing Address - Fax:
Practice Address - Street 1:3776 FORSYTHE WAY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-3049
Practice Address - Country:US
Practice Address - Phone:850-668-6315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 6546235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist