Provider Demographics
NPI:1487871984
Name:CARRIERE, GEORGANNE VICTORIA (MED,CCC-A)
Entity type:Individual
Prefix:MRS
First Name:GEORGANNE
Middle Name:VICTORIA
Last Name:CARRIERE
Suffix:
Gender:F
Credentials:MED,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 E ARLINGTON BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-7843
Mailing Address - Country:US
Mailing Address - Phone:252-321-3277
Mailing Address - Fax:252-321-3271
Practice Address - Street 1:1702 E ARLINGTON BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-7843
Practice Address - Country:US
Practice Address - Phone:252-321-3277
Practice Address - Fax:252-321-3271
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6358231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist