Healthcare Provider Details

I. General information

NPI: 1487871984
Provider Name (Legal Business Name): GEORGANNE VICTORIA CARRIERE M.ED.,CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 E ARLINGTON BLVD SUITE F
GREENVILLE NC
27858-7843
US

IV. Provider business mailing address

1702 E ARLINGTON BLVD SUITE F
GREENVILLE NC
27858-7843
US

V. Phone/Fax

Practice location:
  • Phone: 252-321-3277
  • Fax: 252-321-3271
Mailing address:
  • Phone: 252-321-3277
  • Fax: 252-321-3271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number6358
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: