Provider Demographics
NPI:1861228348
Name:STAPLETON, CAROLINE GRACE
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:GRACE
Last Name:STAPLETON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2759 W ANKLAM RD APT D
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-3711
Mailing Address - Country:US
Mailing Address - Phone:505-977-1570
Mailing Address - Fax:
Practice Address - Street 1:8500 N CONTINENTAL RESERVE LOOP
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-1494
Practice Address - Country:US
Practice Address - Phone:520-352-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP14419235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist