Provider Demographics
NPI:1942323811
Name:ANDERSON, KAREN L (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:L
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4736 TORY SOUND LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-2219
Mailing Address - Country:US
Mailing Address - Phone:850-321-3418
Mailing Address - Fax:
Practice Address - Street 1:4052 BALD CYPRESS WAY
Practice Address - Street 2:BIN A06
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32399-7017
Practice Address - Country:US
Practice Address - Phone:850-245-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY 1061231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist