Provider Demographics
NPI:1205368776
Name:BIGGERSTAFF, KAREN DIANE (MA,CCC-SLP,ATP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:DIANE
Last Name:BIGGERSTAFF
Suffix:
Gender:F
Credentials:MA,CCC-SLP,ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14342 HILL PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1131
Mailing Address - Country:US
Mailing Address - Phone:210-862-7157
Mailing Address - Fax:
Practice Address - Street 1:14342 HILL PRINCE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-1131
Practice Address - Country:US
Practice Address - Phone:210-862-7157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11573235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist