Provider Demographics
NPI:1083849137
Name:WINCHESTER, CAROL (MS SLP CCC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:WINCHESTER
Suffix:
Gender:F
Credentials:MS SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5763 WILENA PL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-1710
Mailing Address - Country:US
Mailing Address - Phone:941-320-8930
Mailing Address - Fax:
Practice Address - Street 1:5763 WILENA PL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-1710
Practice Address - Country:US
Practice Address - Phone:941-320-8930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2829235Z00000X
261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech