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Individual

CARLY SPEED

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
18 N FORT THOMAS AVE STE 302, FORT THOMAS, KY 41075-1595
(859) 441-0139
Mailing address
180 MAGNOLIA AVE, CINCINNATI, OH 45246-4509
(513) 746-5675

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
284679
KY
235Z00000X
Speech-Language Pathologist
COND.20201467
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0406425
OH
Enumeration date
09/10/2020
Last updated
05/22/2023
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