Carla Booker, SLP
Individual provider Active NPI Speech-Language Pathologist · Tupelo, MS
NPI 1659814481 · NPPES record last updated Nov 28, 2016
Key facts
- NPI
- 1659814481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- S1047 (MS)
- Practice address
- 2844 Traceland Dr
Tupelo, MS 38801-4200 - Phone
- (662) 680-3148
- NPI assigned
- Nov 28, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S1047 | MS | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | S1047 | MS | Yes |
Addresses
Primary practice location
2844 Traceland Dr
Tupelo, MS 38801-4200
Mailing address
3828 Braddock Ave
Moss Point, MS 39562-8111
Phone (228) 475-2667
Other providers in Tupelo, MS
- Henry B Boler
- Michael Ted Boler Jr.
- Peggy L Boles
- Dennis Davis Bond Sr.
- Bethany Bonner
- Katelyn C Boren
- Samantha Grace Boren
- Sharon Dugas Boudreaux
- Charles Edward Bouldin
- Keisha Bounds
All providers in Tupelo, MS · Speech-Language Pathologist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.