MEDICARE: MRS. CHRISTINE CARRIER MA, 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	146.005546	IL

General Provider Information

NPI Number	:	1457775132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE CARRIER MA, CCC-SLP

Provider Business Mailing Address
First Line	:	20 S 27TH ST
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62226-6724
Country	:	US
Telephone Number	:	618-233-4132
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 S 27TH ST
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62226-6724
Country	:	US
Telephone Number	:	618-233-4132
Fax Number	:

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

Provider Enumeration Date	:	02/14/2014
Last Update Date	:	02/14/2014

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Directions to “ MRS. CHRISTINE CARRIER MA, CCC-SLP” Practice Location

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