Provider Demographics
NPI:1548910532
Name:GOINS, CARLA L (MED, CALT, SLDT)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:L
Last Name:GOINS
Suffix:
Gender:F
Credentials:MED, CALT, SLDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 HILLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2422
Mailing Address - Country:US
Mailing Address - Phone:703-300-1614
Mailing Address - Fax:
Practice Address - Street 1:1009 HILLWOOD AVE
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2422
Practice Address - Country:US
Practice Address - Phone:571-426-4118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
53031416235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist