Individual
CAROLYN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 YALE AVE, MORTON, PA 19070-1918
(704) 408-1730
Mailing address
1820 CUMBERLAND AVE, CHARLOTTE, NC 28203-6004
(704) 408-1730
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
AT006098
PA
235Z00000X
Speech-Language Pathologist
Primary
SL009422
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT006098
COMMONWEALTH OF PENNSYLVANIA
PA
01
—
SL009422
COMMONWEALTH OF PENNSYLVANIA
PA
Enumeration date
09/08/2005
Last updated
01/06/2009
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