Healthcare Provider Details

I. General information

NPI: 1861315772
Provider Name (Legal Business Name): CARLY WALCUTT MS CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3343 ASPEN GROVE DR STE 240
FRANKLIN TN
37067-2921
US

IV. Provider business mailing address

1935 SAINT JOHNS RD
LASCASSAS TN
37085-5158
US

V. Phone/Fax

Practice location:
  • Phone: 615-651-4833
  • Fax:
Mailing address:
  • Phone: 863-608-4476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6728
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: