Provider Demographics
NPI:1053498261
Name:BEHRENDT, KAREN O (MA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:O
Last Name:BEHRENDT
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 1:102 WOODVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-2254
Mailing Address - Country:US
Mailing Address - Phone:864-984-1966
Mailing Address - Fax:
Practice Address - Street 1:102 WOODVIEW DR
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-2254
Practice Address - Country:US
Practice Address - Phone:864-984-1966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC548235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist