Provider Demographics
NPI:1801038492
Name:CARPENTER, KAREN (MA, CCC-A)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 BROADWAY
Mailing Address - Street 2:130
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305
Mailing Address - Country:US
Mailing Address - Phone:720-848-9265
Mailing Address - Fax:720-848-9238
Practice Address - Street 1:350 BROADWAY
Practice Address - Street 2:130
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305
Practice Address - Country:US
Practice Address - Phone:720-848-9265
Practice Address - Fax:720-848-9238
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO124231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist