Provider Demographics
NPI:1477780112
Name:TUSA, KAREN ANN (LSLP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ANN
Last Name:TUSA
Suffix:
Gender:F
Credentials:LSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CORINA CT
Mailing Address - Street 2:
Mailing Address - City:WATERVLIET
Mailing Address - State:NY
Mailing Address - Zip Code:12189-1136
Mailing Address - Country:US
Mailing Address - Phone:518-237-7948
Mailing Address - Fax:
Practice Address - Street 1:11 CORINA CT
Practice Address - Street 2:
Practice Address - City:WATERVLIET
Practice Address - State:NY
Practice Address - Zip Code:12189-1136
Practice Address - Country:US
Practice Address - Phone:518-237-7948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-21
Last Update Date:2009-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4762235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist