Provider Demographics
NPI:1720369333
Name:DOERRFELD, KAREN D (SLP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:D
Last Name:DOERRFELD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 177
Mailing Address - Street 2:
Mailing Address - City:ELLIOTTVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40317-0177
Mailing Address - Country:US
Mailing Address - Phone:606-784-9226
Mailing Address - Fax:
Practice Address - Street 1:662 L.COOPER RD.
Practice Address - Street 2:
Practice Address - City:ELLIOTTVILLE
Practice Address - State:KY
Practice Address - Zip Code:40317
Practice Address - Country:US
Practice Address - Phone:606-784-9226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0637235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist