MEDICARE: MYESHA CARTER MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	05780	MD

General Provider Information

NPI Number	:	1033444799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYESHA CARTER MS, CCC-SLP

Provider Business Mailing Address
First Line	:	PO BOX 29680
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017-4008
Country	:	US
Telephone Number	:	202-832-5390
Fax Number	:	202-832-8494

Provider Business Practice Location Address
First Line	:	3321 12TH ST NE
Second Line	:	STE. 2
City	:	WASHINGTON
State	:	DC
Zip	:	20017-4008
Country	:	US
Telephone Number	:	202-832-3590
Fax Number	:	202-832-8494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2009
Last Update Date	:	10/13/2009

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Directions to “ MYESHA CARTER MS, CCC-SLP” Practice Location

Language	Start Address	Practice Location

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