Provider Demographics
NPI:1871750315
Name:EDWARDS MALONE, CARRIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:
Last Name:EDWARDS MALONE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:CARRIE
Other - Middle Name:LYN
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1013 MOORELAND DR
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-6245
Mailing Address - Country:US
Mailing Address - Phone:270-792-4570
Mailing Address - Fax:
Practice Address - Street 1:1013 MOORELAND DR
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-6245
Practice Address - Country:US
Practice Address - Phone:270-792-4570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY142412235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist