Individual
MRS. CARRIE E THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCCSLP
Contact information
Practice address
2128 ELMWOOD AVE, BUFFALO, NY 14200-1910
(716) 874-4500
(716) 874-3195
Mailing address
2128 ELMWOOD AVE, BUFFALO, NY 14200-1910
(716) 874-4500
(716) 874-3195
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
018173
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01465154
—
NY
Enumeration date
05/29/2008
Last updated
03/23/2010
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