Provider Demographics
NPI:1912183997
Name:VENDITTO, KAREN T (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:T
Last Name:VENDITTO
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 SALEM ST
Mailing Address - Street 2:BUILDING A
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940-2600
Mailing Address - Country:US
Mailing Address - Phone:781-246-4225
Mailing Address - Fax:
Practice Address - Street 1:1127 COMMONWEALTH AVE
Practice Address - Street 2:#31
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-3203
Practice Address - Country:US
Practice Address - Phone:203-444-4876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7319235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist