Marla K Carnes, MS--SLP

Individual provider Active NPI Speech-Language Pathologist · Altus, OK

NPI 1194802439 · NPPES record last updated Oct 15, 2024

Key facts

NPI
1194802439
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2393 (OK)
Practice address
1216 Karen Dr
Altus, OK 73521-6935
Phone
(580) 284-7408
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2393OKMDDental Hygienist
102597TXMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 102597 TX
Speech-Language Pathologist 235Z00000X 2393 OK Yes

Addresses

Primary practice location

1216 Karen Dr
Altus, OK 73521-6935

Mailing address

1216 Karen Dr
Altus, OK 73521-6935
Phone (580) 284-7408

Other practice location 1

1005 Midwestern Pkwy
Wichita Falls, TX 76302-2211
Phone (940) 322-0771

Other identifiers

IdentifierTypeStateIssuer
111408402MedicaidTX
87623TOtherTXBCBS OF TEXAS #
111408401MedicaidTX

Other providers in Altus, OK

All providers in Altus, OK · Speech-Language Pathologist in Oklahoma

Sources for this page

Verify at the official NPI Registry.