Provider Demographics
NPI:1043485832
Name:BADARNI, CAROLE JEAN (MA, CCC/SLP)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:JEAN
Last Name:BADARNI
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10501 N CRESCENT LN
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-8681
Mailing Address - Country:US
Mailing Address - Phone:352-227-4095
Mailing Address - Fax:
Practice Address - Street 1:10501 N CRESCENT LN
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-8681
Practice Address - Country:US
Practice Address - Phone:352-227-4095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA1804235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL880371400Medicaid