Individual
MRS. CINDY K CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS. CCC-SLP
Contact information
Practice address
3801 KERN WAY, YAKIMA, WA 98902-6340
(509) 574-3228
(509) 574-3210
Mailing address
1620 S 68TH AVE, YAKIMA, WA 98908-5601
(509) 388-8070
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12051791
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12051791
ASHA AFFILIATION STATUS AND CERTIFICATION 12051791
WA
05
—
LL00003595
—
WA
Enumeration date
05/29/2013
Last updated
05/29/2013
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