Provider Demographics
NPI:1487263331
Name:SAUNDERS, CARLY ISABEL
Entity type:Individual
Prefix:MS
First Name:CARLY
Middle Name:ISABEL
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 CAUMSETT WOODS LN
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1245
Mailing Address - Country:US
Mailing Address - Phone:516-998-6680
Mailing Address - Fax:
Practice Address - Street 1:33 CAUMSETT WOODS LN
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1245
Practice Address - Country:US
Practice Address - Phone:516-998-6680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist