Provider Demographics
NPI:1942033212
Name:BRADY, CARLA MARIE (SLP)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:MARIE
Last Name:BRADY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-1732
Mailing Address - Country:US
Mailing Address - Phone:508-767-0804
Mailing Address - Fax:
Practice Address - Street 1:14 OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-1732
Practice Address - Country:US
Practice Address - Phone:508-767-0804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASLP7185235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist