Provider Demographics
NPI:1710013800
Name:DALE, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DALE
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 1:117 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3747
Mailing Address - Country:US
Mailing Address - Phone:603-354-6673
Mailing Address - Fax:603-357-9267
Practice Address - Street 1:194 PLEASANT ST STE 2
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2915
Practice Address - Country:US
Practice Address - Phone:603-354-6673
Practice Address - Fax:603-357-9267
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHA556231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30436843Medicaid
NH30436843Medicaid