Provider Demographics
NPI:1386856417
Name:WHITLA-SIMONS, KARIN (BA ASST SLP)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:
Last Name:WHITLA-SIMONS
Suffix:
Gender:F
Credentials:BA ASST SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 HORIZON NORTH PARKWAY
Mailing Address - Street 2:APT 1126
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287
Mailing Address - Country:US
Mailing Address - Phone:469-834-6985
Mailing Address - Fax:
Practice Address - Street 1:2535 LONE STAR DR.
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75212
Practice Address - Country:US
Practice Address - Phone:214-467-9787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX331362355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant