Healthcare Provider Details

I. General information

NPI: 1316131527
Provider Name (Legal Business Name): CARON L PLOWMAN MA CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 07/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10524 BROWNSVILLE AVE
LAS VEGAS NV
89129-3217
US

IV. Provider business mailing address

10524 BROWNSVILLE AVE
LAS VEGAS NV
89129-3217
US

V. Phone/Fax

Practice location:
  • Phone: 702-419-6432
  • Fax:
Mailing address:
  • Phone: 702-419-6432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP322
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: