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General NPI Number Information
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NPI Number | 1043580210
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Entity Type | Individual
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Provider Name | TABER CARPENTER CATILLAZ MED. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/05/2012
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Last Update Date | 12/01/2023
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Provider Practice Location Address
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Address Line | 37 JACKSON ST
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-4807
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Country | US
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Telephone | 757-630-3126
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Fax |
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Provider Business Mailing Address
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Address Line | 127 N JEFFERSON ST UPPR LEVEL
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City | STAUNTON
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State | VA
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Zip | 24401-3341
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Country | US
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Telephone | 757-630-3126
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202006546
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 022382-01
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License Number State | NY
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