Provider Demographics
NPI:1669858825
Name:SHOEMAKER, KAREN (MA,CCC/SLP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SHOEMAKER
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 1:26420 KENSINGTON PL
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-5120
Mailing Address - Country:US
Mailing Address - Phone:251-517-0355
Mailing Address - Fax:251-625-1969
Practice Address - Street 1:26420 KENSINGTON PL
Practice Address - Street 2:SUITE C
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-5120
Practice Address - Country:US
Practice Address - Phone:251-517-0355
Practice Address - Fax:251-625-1969
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3786235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist