Provider Demographics
NPI:1437375466
Name:BLAESING, KAREN JEAN (PHD CCCSLP)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:JEAN
Last Name:BLAESING
Suffix:
Gender:F
Credentials:PHD CCCSLP
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Other - Credentials:
Mailing Address - Street 1:411 SW 24TH STREET
Mailing Address - Street 2:HARRY JERSIG CENTER OUR LADY OF THE LAKE UNIVERSITY
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-4689
Mailing Address - Country:US
Mailing Address - Phone:210-434-6711
Mailing Address - Fax:210-434-9360
Practice Address - Street 1:411 SW 24TH STREET
Practice Address - Street 2:HARRY JERSIG CENTER OUR LADY OF THE LAKE UNIVERSITY
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-4689
Practice Address - Country:US
Practice Address - Phone:210-434-6711
Practice Address - Fax:210-434-9360
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX17846235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87860TOtherBCBS TX