Provider Demographics
NPI:1477009447
Name:KING, KAREN JAYNE (CCC/SLP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:JAYNE
Last Name:KING
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5315 KINGSMILL RD
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-3013
Mailing Address - Country:US
Mailing Address - Phone:713-882-4161
Mailing Address - Fax:
Practice Address - Street 1:5315 KINGSMILL RD
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3013
Practice Address - Country:US
Practice Address - Phone:713-882-4161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10437235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist