Provider Demographics
NPI:1427228550
Name:FLYNN, KARI ANNE (MS/CCC/SLP)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:ANNE
Last Name:FLYNN
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 1:14901 FROST AVE
Mailing Address - Street 2:APT 34
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-4237
Mailing Address - Country:US
Mailing Address - Phone:908-839-3314
Mailing Address - Fax:
Practice Address - Street 1:4706 QUAIL RIDGE DR
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-4237
Practice Address - Country:US
Practice Address - Phone:609-577-5465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP15196235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist