Provider Demographics
NPI:1285832220
Name:LARSON, KARIN R (MA-CCC/SLP)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:R
Last Name:LARSON
Suffix:
Gender:F
Credentials:MA-CCC/SLP
Other - Prefix:
Other - First Name:KARIN
Other - Middle Name:R
Other - Last Name:ROZUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1284
Mailing Address - Street 2:501 WEST HAVENS SUITE 103
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-7284
Mailing Address - Country:US
Mailing Address - Phone:605-995-6044
Mailing Address - Fax:605-995-6044
Practice Address - Street 1:501 W HAVENS AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-4334
Practice Address - Country:US
Practice Address - Phone:605-995-6044
Practice Address - Fax:605-995-6044
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist