Provider Demographics
NPI:1821806126
Name:MARTA, CAROLINE R (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:R
Last Name:MARTA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 ANAPUNI ST APT C
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-4418
Mailing Address - Country:US
Mailing Address - Phone:267-303-3049
Mailing Address - Fax:
Practice Address - Street 1:94-216 FARRINGTON HWY STE 301
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1922
Practice Address - Country:US
Practice Address - Phone:808-676-5584
Practice Address - Fax:808-676-5587
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HISP-2343235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist