Provider Demographics
NPI:1407009756
Name:RENAUD, KARLA ANN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:ANN
Last Name:RENAUD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 CLERMONT ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-2407
Mailing Address - Country:US
Mailing Address - Phone:518-453-8376
Mailing Address - Fax:
Practice Address - Street 1:70 CLERMONT ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-2407
Practice Address - Country:US
Practice Address - Phone:518-453-8376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011742235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist