Healthcare Provider Details

I. General information

NPI: 1316693377
Provider Name (Legal Business Name): KIMBERLY CARTER THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2022
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 JULIA ST
RAYVILLE LA
71269-2609
US

IV. Provider business mailing address

817 JULIA ST
RAYVILLE LA
71269-2609
US

V. Phone/Fax

Practice location:
  • Phone: 318-548-6925
  • Fax: 866-434-2902
Mailing address:
  • Phone: 318-548-6925
  • Fax: 866-434-2902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY DENISE CARTER
Title or Position: OWNER
Credential: MA, CCC-SLP
Phone: 318-548-6925