Provider Demographics
NPI:1124318365
Name:KERSCHER, CARRIE A (SLP)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:A
Last Name:KERSCHER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:SHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:150 N MILLER RD STE 150A150N
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3770
Mailing Address - Country:US
Mailing Address - Phone:330-867-2240
Mailing Address - Fax:
Practice Address - Street 1:3222 DRAPER AVENUE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-3830
Practice Address - Country:US
Practice Address - Phone:704-351-1964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9092235Z00000X
OHSP.12435235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist