Provider Demographics
NPI:1306190111
Name:CARLA AUBREY - SPEECH PATHOLOGIST, LLC
Entity type:Organization
Organization Name:CARLA AUBREY - SPEECH PATHOLOGIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:C
Authorized Official - Last Name:AUBREY
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:214-636-4034
Mailing Address - Street 1:7161 KENDALLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5510
Mailing Address - Country:US
Mailing Address - Phone:213-636-4034
Mailing Address - Fax:
Practice Address - Street 1:7161 KENDALLWOOD DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-5510
Practice Address - Country:US
Practice Address - Phone:213-636-4034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16272235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty