Provider Demographics
NPI:1417486473
Name:DZIARNOWSKI, KAROLINA
Entity Type:Individual
Prefix:
First Name:KAROLINA
Middle Name:
Last Name:DZIARNOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 HOWELL ST APT 3
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-1150
Mailing Address - Country:US
Mailing Address - Phone:860-869-1168
Mailing Address - Fax:
Practice Address - Street 1:55 TOZER RD
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5515
Practice Address - Country:US
Practice Address - Phone:978-969-2894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76523-SP-SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist