Provider Demographics
NPI:1346525532
Name:MIRSKY, KAREN WALKER (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:WALKER
Last Name:MIRSKY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 MANDALAY BAY DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4300
Mailing Address - Country:US
Mailing Address - Phone:214-677-5151
Mailing Address - Fax:
Practice Address - Street 1:744 MANDALAY BAY DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75056-4300
Practice Address - Country:US
Practice Address - Phone:214-677-5151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100842235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist