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NPI Code Detail

MEDICARE: MRS. WANDA L CAREY CDS

MEDICARE:  MRS. WANDA L CAREY  CDS
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
1235500000XSpeech/Language/Hearing Specialist/Technologist
2251C00000XDevelopmentally Disabled Services Day Training Agency
3251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1457547556
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. WANDA L CAREY CDS
Provider Business Mailing Address
First Line : 29302 BIERI RD
Second Line :
City : CALIFORNIA
State : MO
Zip : 65018-3320
Country : US
Telephone Number : 573-796-8253
Fax Number : 573-796-3921
Provider Business Practice Location Address
First Line : 29302 BIERI RD
Second Line :
City : CALIFORNIA
State : MO
Zip : 65018-3320
Country : US
Telephone Number : 573-796-8253
Fax Number : 573-796-3921
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2007
Last Update Date : 09/21/2007

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Directions to “ MRS. WANDA L CAREY CDS” Practice Location

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