Provider Demographics
NPI:1073779971
Name:CASADABAN, KAREN (SLP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CASADABAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LEA
Other - Last Name:REECE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4957 DAY LILY WAY
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102
Mailing Address - Country:US
Mailing Address - Phone:770-592-4313
Mailing Address - Fax:770-592-4314
Practice Address - Street 1:4957 DAY LILY WAY
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102
Practice Address - Country:US
Practice Address - Phone:770-592-4313
Practice Address - Fax:770-592-4314
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist