MEDICARE: MRS. CARRIE ALLISON COUCH 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	102490	TX

General Provider Information

NPI Number	:	1992434187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARRIE ALLISON COUCH MS, CCC/SLP

Provider Business Mailing Address
First Line	:	7730 FM 925 W
Second Line	:
City	:	VERNON
State	:	TX
Zip	:	76384-2780
Country	:	US
Telephone Number	:	817-312-8419
Fax Number	:

Provider Business Practice Location Address
First Line	:	1713 WILBARGER ST
Second Line	:
City	:	VERNON
State	:	TX
Zip	:	76384-4741
Country	:	US
Telephone Number	:	817-312-8419
Fax Number	:

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

Provider Enumeration Date	:	06/06/2022
Last Update Date	:	06/06/2022

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Directions to “ MRS. CARRIE ALLISON COUCH MS, CCC/SLP” Practice Location

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