Provider Demographics
NPI:1437434198
Name:KASTRUP, KARLA ANN
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:ANN
Last Name:KASTRUP
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 1:410 E 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:MILBANK
Mailing Address - State:SD
Mailing Address - Zip Code:57252-3307
Mailing Address - Country:US
Mailing Address - Phone:605-432-6615
Mailing Address - Fax:605-432-6286
Practice Address - Street 1:410 E 10TH AVE
Practice Address - Street 2:
Practice Address - City:MILBANK
Practice Address - State:SD
Practice Address - Zip Code:57252-3307
Practice Address - Country:US
Practice Address - Phone:605-432-6615
Practice Address - Fax:605-432-6286
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD68252-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist