Provider Demographics
NPI:1275004285
Name:WARD, KARI ANN (SLP)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:ANN
Last Name:WARD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2965 E TARPON DR STE 150
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-9007
Mailing Address - Country:US
Mailing Address - Phone:075-547-8613
Mailing Address - Fax:307-215-0015
Practice Address - Street 1:1930 E 12TH ST
Practice Address - Street 2:STE 106
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-4076
Practice Address - Country:US
Practice Address - Phone:307-554-7861
Practice Address - Fax:307-215-0015
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYSP-640235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist