Provider Demographics
NPI:1629107388
Name:SANACORE, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SANACORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 PARK MANOR TER NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-1455
Mailing Address - Country:US
Mailing Address - Phone:404-290-1960
Mailing Address - Fax:770-423-4465
Practice Address - Street 1:1040 PARK MANOR TER NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-1455
Practice Address - Country:US
Practice Address - Phone:404-290-1960
Practice Address - Fax:770-423-4465
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005111235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist