Provider Demographics
NPI:1619235439
Name:WIGHT, KAREN MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:MARIE
Last Name:WIGHT
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Gender:F
Credentials:MS, CCC-SLP
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Other - First Name:
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Mailing Address - Street 1:1115 TAMARACK RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6984
Mailing Address - Country:US
Mailing Address - Phone:270-926-8534
Mailing Address - Fax:270-685-2058
Practice Address - Street 1:1115 TAMARACK RD
Practice Address - Street 2:SUITE 400
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-6984
Practice Address - Country:US
Practice Address - Phone:270-926-8534
Practice Address - Fax:270-685-2058
Is Sole Proprietor?:No
Enumeration Date:2012-04-30
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY0442235Z00000X
IN22002700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist