Provider Demographics
NPI:1659898344
Name:WAITE, KARA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:WAITE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 RIVERSIDE DR UNIT 327
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3086
Mailing Address - Country:US
Mailing Address - Phone:614-507-2032
Mailing Address - Fax:
Practice Address - Street 1:380 GRANVILLE ST
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-2947
Practice Address - Country:US
Practice Address - Phone:614-269-4780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11630235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist