Provider Demographics
NPI:1932558905
Name:BULLINGTON, CAROLYN (HAS)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:BULLINGTON
Suffix:
Gender:F
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LONG CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-9781
Mailing Address - Country:US
Mailing Address - Phone:864-940-5694
Mailing Address - Fax:
Practice Address - Street 1:3260 HOLMESTOWN RD UNIT A2
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-7494
Practice Address - Country:US
Practice Address - Phone:843-663-8393
Practice Address - Fax:843-663-8393
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHAS0407237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist