Provider Demographics
NPI:1831418391
Name:DUNCAN, CARRIE C (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:C
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 BYWATER TRL
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-6703
Mailing Address - Country:US
Mailing Address - Phone:770-490-8579
Mailing Address - Fax:
Practice Address - Street 1:3105 BYWATER TRL
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-6703
Practice Address - Country:US
Practice Address - Phone:770-490-8579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003688235Z00000X
GA010386235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist