Provider Demographics
NPI:1437647914
Name:EDMUNDS, KARISE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KARISE
Middle Name:
Last Name:EDMUNDS
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 1:6375 GOLDFINCH DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3713
Mailing Address - Country:US
Mailing Address - Phone:797-733-0614
Mailing Address - Fax:
Practice Address - Street 1:6375 GOLDFINCH DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-3713
Practice Address - Country:US
Practice Address - Phone:614-797-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3249041235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist