Provider Demographics
NPI:1861565707
Name:MILLER-BAYER, CAROLINE ANNE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:ANNE
Last Name:MILLER-BAYER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:909 COUNTRY CLUB DR SE APT G
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-2205
Mailing Address - Country:US
Mailing Address - Phone:414-418-1848
Mailing Address - Fax:
Practice Address - Street 1:5100 MARNA LYNN AVE NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5701
Practice Address - Country:US
Practice Address - Phone:505-898-0923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2905-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMSLP-2023-0214OtherSTATE SLP LICENSE
CASP 13539OtherSTATE SLP LICENSE
WI2905-154OtherSTATE SLP LICENSE
NM420205OtherPED LICENSE