Provider Demographics
NPI:1043436660
Name:MUSENGWA, KAREN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MUSENGWA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 PINE BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-7111
Mailing Address - Country:US
Mailing Address - Phone:410-713-2796
Mailing Address - Fax:
Practice Address - Street 1:1006 MARKET ST
Practice Address - Street 2:
Practice Address - City:POCOMOKE CITY
Practice Address - State:MD
Practice Address - Zip Code:21851-1206
Practice Address - Country:US
Practice Address - Phone:410-957-2252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04975235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist