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Individual

MRS. CAROLYN JEAN CARR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS-CCC-SLP

Contact information

Practice address
15441 MALLORY CT, MOORPARK, CA 93021-3253
(805) 523-1575
(480) 287-8340
Mailing address
15441 MALLORY CT, MOORPARK, CA 93021-3253
(805) 523-1575
(480) 287-8340

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP11314
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SP0113140
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
10/31/2008
Last updated
10/31/2008
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