Individual
MRS. CARISSA D FOLSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 COMMODORE BLVD, MELBOURNE, FL 32935-4199
(321) 242-6400
Mailing address
1500 MORGAN CT, MELBOURNE, FL 32934-9083
(321) 508-6937
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA14948
FL
Other
Enumeration date
02/02/2023
Last updated
02/02/2023
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