Basic Information
| Provider Information | |||||||||
| NPI: | 1255659793 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROYAL-EVANS | ||||||||
| FirstName: | CAROLINE | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | M.S., CCC, BC-ANCDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 850 POPLAR AVE BLDG 2 | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381054607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012875565 | ||||||||
| FaxNumber: | 9012876804 | ||||||||
| Practice Location | |||||||||
| Address1: | 4055 N PARK LOOP | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381525042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9016782009 | ||||||||
| FaxNumber: | 9016785497 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2010 | ||||||||
| LastUpdateDate: | 05/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 1227 | TN | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.