Provider Demographics
NPI:1780178574
Name:GUILEY, CARISSA N (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CARISSA
Middle Name:N
Last Name:GUILEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MISS
Other - First Name:CARISSA
Other - Middle Name:N
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17791 FJORD DR NE STE 138
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8483
Mailing Address - Country:US
Mailing Address - Phone:615-767-4639
Mailing Address - Fax:360-824-6944
Practice Address - Street 1:17791 FJORD DR NE STE 138
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-8483
Practice Address - Country:US
Practice Address - Phone:615-767-4639
Practice Address - Fax:360-824-6944
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-316642174N00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN