Provider Demographics
NPI:1528347036
Name:CARPENTER, DASCHIA D (SLP)
Entity type:Individual
Prefix:
First Name:DASCHIA
Middle Name:D
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:DASCHIA
Other - Middle Name:D
Other - Last Name:VANOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1017 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MO
Mailing Address - Zip Code:64085-1911
Mailing Address - Country:US
Mailing Address - Phone:816-776-6912
Mailing Address - Fax:
Practice Address - Street 1:1017 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MO
Practice Address - Zip Code:64085-1911
Practice Address - Country:US
Practice Address - Phone:816-776-6912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011020912235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist