Individual
CARLY E IMLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC/SLP
Contact information
Practice address
275 SHOMONT DR, HARBORCREEK, PA 16421-1228
(814) 602-0436
(814) 520-5352
Mailing address
275 SHOMONT DR, HARBORCREEK, PA 16421-1228
(814) 602-0436
(814) 520-5352
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL015018
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14262144
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
—
01
—
SL015018
STATE BOARD OF SPEECH PATHOLOGY AND AUDIOLOGY
PA
Enumeration date
03/03/2020
Last updated
03/06/2020
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