Healthcare Provider Details

I. General information

NPI: 1760725170
Provider Name (Legal Business Name): CAROLYN ANN HOVEY M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 AMY LEE CIR
PORT ORANGE FL
32127-7542
US

IV. Provider business mailing address

617 AMY LEE CIR
PORT ORANGE FL
32127-7542
US

V. Phone/Fax

Practice location:
  • Phone: 386-212-4432
  • Fax:
Mailing address:
  • Phone: 386-212-4432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA2290
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: