MEDICARE: MARY CARRIER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	271751	KY

General Provider Information

NPI Number	:	1528857257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY CARRIER

Provider Business Mailing Address
First Line	:	128 E PIKE ST
Second Line	:
City	:	CYNTHIANA
State	:	KY
Zip	:	41031-1526
Country	:	US
Telephone Number	:	859-534-8206
Fax Number	:	859-347-3991

Provider Business Practice Location Address
First Line	:	128 E PIKE ST
Second Line	:
City	:	CYNTHIANA
State	:	KY
Zip	:	41031-1526
Country	:	US
Telephone Number	:	859-534-8206
Fax Number	:	859-347-3991

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2025
Last Update Date	:	04/30/2025

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Directions to “ MARY CARRIER ” Practice Location

Language	Start Address	Practice Location

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