Provider Demographics
NPI:1578989067
Name:ACRICHE, KARYN
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:
Last Name:ACRICHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARYN
Other - Middle Name:
Other - Last Name:CZUBAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:138 INDUSTRY LN STE 5A
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-1741
Mailing Address - Country:US
Mailing Address - Phone:443-752-1617
Mailing Address - Fax:
Practice Address - Street 1:138 INDUSTRY LN STE 5A
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-1741
Practice Address - Country:US
Practice Address - Phone:443-752-1617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-09
Last Update Date:2014-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06072235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist