Provider Demographics
NPI:1407283435
Name:MEINZER, KAREN M (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:MEINZER
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 1:405 EDGEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WAKE VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75501-8611
Mailing Address - Country:US
Mailing Address - Phone:903-831-4981
Mailing Address - Fax:
Practice Address - Street 1:405 EDGEWOOD LN
Practice Address - Street 2:
Practice Address - City:WAKE VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75501-8611
Practice Address - Country:US
Practice Address - Phone:903-831-4981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1402235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist