Provider Demographics
NPI:1457689242
Name:SPECK, KAREN KAY SOCIAS I (PT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN KAY
Middle Name:SOCIAS
Last Name:SPECK
Suffix:I
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:KAREN KAY
Other - Middle Name:HAO CUENCO
Other - Last Name:SOCIAS
Other - Suffix:I
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1865 ISSAQUAH ST
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-4424
Mailing Address - Country:US
Mailing Address - Phone:330-949-3796
Mailing Address - Fax:
Practice Address - Street 1:4557 QUICK RD
Practice Address - Street 2:
Practice Address - City:PENINSULA
Practice Address - State:OH
Practice Address - Zip Code:44264-9794
Practice Address - Country:US
Practice Address - Phone:330-923-7828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2016-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH012140225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist