Basic Information
Provider Information
NPI: 1336621556
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARTY
FirstName: YVETTE
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: M.S., CF-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: THOMPSON
OtherFirstName: YVETTE
OtherMiddleName: D
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1200 1ST ST NE FL 9
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200027953
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1200 1ST ST NE FL 9
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200027953
CountryCode: US
TelephoneNumber: 2024425885
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/04/2018
LastUpdateDate: 09/04/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X  Y Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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