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General NPI Number Information
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NPI Number | 1578884730
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Entity Type | Individual
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Provider Name | MATTHEW CAREY CCC-SLP
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Gender | Male
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Dates
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Enumeration Date | 06/22/2010
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Last Update Date | 06/22/2010
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Provider Practice Location Address
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Address Line | 1605 2ND ST
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City | EARLE
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State | AR
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Zip | 72331-1634
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Country | US
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Telephone | 870-792-7868
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Fax | 870-792-7868
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Provider Business Mailing Address
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Address Line | PO BOX 2418
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City | WEST MEMPHIS
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State | AR
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Zip | 72303-2418
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Country | US
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Telephone | 870-792-7868
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Fax | 870-792-7868
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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 | P8191
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License Number State | AR
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