Jaclyn Carr
Individual provider Active NPI Speech-Language Pathologist · Wilmington, DE
NPI 1750002879 · NPPES record last updated Sep 7, 2022
Key facts
- NPI
- 1750002879
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- O1-0001772 (DE)
- Practice address
- 1311 Brandywine Blvd
Wilmington, DE 19809-2306 - Phone
- (302) 529-3118
- NPI assigned
- Sep 7, 2022
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| O1-0001772 | DE | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | O1-0001772 | DE | Yes |
Addresses
Primary practice location
1311 Brandywine Blvd
Wilmington, DE 19809-2306
Mailing address
1311 Brandywine Blvd
Wilmington, DE 19809-2306
Other providers in Wilmington, DE
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- Marie Caron
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- Dennis J Carradin
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All providers in Wilmington, DE · Speech-Language Pathologist in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2022. 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.