Provider Demographics
NPI:1174513121
Name:CARBY-JOSEPH, NATASHA A (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:A
Last Name:CARBY-JOSEPH
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 LAKE UNDERHILL RD STE 249
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4513
Mailing Address - Country:US
Mailing Address - Phone:407-249-3344
Mailing Address - Fax:407-378-2978
Practice Address - Street 1:12301 LAKE UNDERHILL RD STE 249
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4513
Practice Address - Country:US
Practice Address - Phone:407-249-3344
Practice Address - Fax:407-378-2978
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7333235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8905495 00Medicaid