Individual
MS. ANDREA C DICARLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC/SLP
Contact information
Practice address
6170 DOE HAVEN DR, FARMINGTON, NY 14425-1153
(585) 742-3118
Mailing address
6170 DOE HAVEN DR, FARMINGTON, NY 14425-1153
(585) 742-3118
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
006980-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006980-1
NY STATE LICENSE SPEECH LANGUAGE PATHOLOGY
NY
Enumeration date
01/11/2011
Last updated
01/11/2011
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