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NPI Code Detail

MEDICARE: CARLY F PROCTOR

MEDICARE: CARLY F PROCTOR
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
1374U00000XHome Health Aide
2235Z00000XSpeech-Language PathologistSLP-2528WV
3235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1740877927
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLY F PROCTOR
Provider Business Mailing Address
First Line : 154 E MAIN ST
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-2160
Country : US
Telephone Number : 304-933-3073
Fax Number :
Provider Business Practice Location Address
First Line : 154 E MAIN ST
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-2160
Country : US
Telephone Number : 304-933-3073
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2020
Last Update Date : 05/19/2025

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Directions to “ CARLY F PROCTOR ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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