Provider Demographics
NPI:1033469010
Name:MAHAN, KAREN L (SLPD CCC-SLP)
Entity Type:Individual
Prefix:PROF
First Name:KAREN
Middle Name:L
Last Name:MAHAN
Suffix:
Gender:F
Credentials:SLPD CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5112 S BARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5001
Mailing Address - Country:US
Mailing Address - Phone:605-371-0404
Mailing Address - Fax:
Practice Address - Street 1:5112 S BARRINGTON DR
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5001
Practice Address - Country:US
Practice Address - Phone:605-371-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist