Provider Demographics
NPI:1063833689
Name:WARNER, KLARAN W (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KLARAN
Middle Name:W
Last Name:WARNER
Suffix:
Gender:F
Credentials: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:PO BOX 582
Mailing Address - Street 2:
Mailing Address - City:GRANTHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03753
Mailing Address - Country:US
Mailing Address - Phone:603-863-0738
Mailing Address - Fax:
Practice Address - Street 1:30 SARGENT RD.
Practice Address - Street 2:
Practice Address - City:SUNAPEE
Practice Address - State:NH
Practice Address - Zip Code:03782
Practice Address - Country:US
Practice Address - Phone:603-873-4678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0512235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist