Provider Demographics
NPI:1407734932
Name:CARR, MARISHA NADINE (MS)
Entity type:Individual
Prefix:
First Name:MARISHA
Middle Name:NADINE
Last Name:CARR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MARISHA
Other - Middle Name:NADINE
Other - Last Name:POORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2715 STATESVILLE BLVD UNIT 610
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-6488
Mailing Address - Country:US
Mailing Address - Phone:304-809-5667
Mailing Address - Fax:
Practice Address - Street 1:877 HILL EVERHART RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27295-9140
Practice Address - Country:US
Practice Address - Phone:336-248-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30004464235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist