Provider Demographics
NPI:1629308101
Name:COMEAU, KAREN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:COMEAU
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:MARIE
Other - Last Name:FIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:9271 PINE COVE RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34224-8901
Mailing Address - Country:US
Mailing Address - Phone:978-852-3553
Mailing Address - Fax:
Practice Address - Street 1:9271 PINE COVE RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34224-8901
Practice Address - Country:US
Practice Address - Phone:978-852-3553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 10248235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist