Provider Demographics
NPI:1285675462
Name:ONG, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:ONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 E POTTER DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-4123
Mailing Address - Country:US
Mailing Address - Phone:602-222-6412
Mailing Address - Fax:
Practice Address - Street 1:650 E INDIAN SCHOOL RD (126)
Practice Address - Street 2:CARL T HAYDEN VAMC
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:95012
Practice Address - Country:US
Practice Address - Phone:602-222-6412
Practice Address - Fax:602-222-6588
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA804231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist