Provider Demographics
NPI:1770929127
Name:NAPOLITANO, CARLA J
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:J
Last Name:NAPOLITANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-5303
Mailing Address - Country:US
Mailing Address - Phone:417-875-5400
Mailing Address - Fax:417-449-3190
Practice Address - Street 1:301 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-5303
Practice Address - Country:US
Practice Address - Phone:417-875-5400
Practice Address - Fax:417-449-3190
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009015707235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist