Provider Demographics
NPI:1578791968
Name:DAMAN, KARA MICHELLE (SLP/CCC)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:MICHELLE
Last Name:DAMAN
Suffix:
Gender:F
Credentials:SLP/CCC
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:MICHELLE
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP/CCC
Mailing Address - Street 1:6022 S. LINDBERGH BLVD.
Mailing Address - Street 2:STE. 100
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123
Mailing Address - Country:US
Mailing Address - Phone:314-845-7751
Mailing Address - Fax:314-845-7752
Practice Address - Street 1:6022 S. LINDBERGH BLVD.
Practice Address - Street 2:STE. 100
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123
Practice Address - Country:US
Practice Address - Phone:314-845-7751
Practice Address - Fax:314-845-7752
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO200913977235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist