Provider Demographics
NPI:1316015183
Name:HOUGH, KAREN SJOSTEDT (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SJOSTEDT
Last Name:HOUGH
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1862 CASTLE WOODS DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1808
Mailing Address - Country:US
Mailing Address - Phone:727-797-5659
Mailing Address - Fax:727-797-5659
Practice Address - Street 1:1862 CASTLE WOODS DR
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1808
Practice Address - Country:US
Practice Address - Phone:727-797-5659
Practice Address - Fax:727-797-5659
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 756235Z00000X
FLSA756222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000121800Medicaid
FL8817782Medicaid