Carol Bocker, SLP

Individual provider Active NPI Speech-Language Pathologist · Jackson, WY

NPI 1982955001 · NPPES record last updated Sep 28, 2012

Key facts

NPI
1982955001
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP149 (WY)
Practice address
555 E Broadway Ave
Suite 100
Jackson, WY 83001-8640
Phone
(307) 739-1864
NPI assigned
Sep 28, 2012
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
SP149WYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP149 WY Yes

Addresses

Primary practice location

555 E Broadway Ave
Suite 100
Jackson, WY 83001-8640

Mailing address

8259 Wicker Ave
Saint John, IN 46373-8878
Phone (219) 365-6560

Other providers in Jackson, WY

All providers in Jackson, WY · Speech-Language Pathologist in Wyoming

Sources for this page

Verify at the official NPI Registry.