Provider Demographics
NPI:1629071634
Name:DITTY, KAREN MARKUSON (AUD CCC-A)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MARKUSON
Last Name:DITTY
Suffix:
Gender:F
Credentials:AUD CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14871 SKINNER RD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-1694
Mailing Address - Country:US
Mailing Address - Phone:832-455-6261
Mailing Address - Fax:
Practice Address - Street 1:6700 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-4906
Practice Address - Country:US
Practice Address - Phone:832-455-6261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51353231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist