Provider Demographics
NPI:1952450348
Name:SHAPIRO, KAREN (MED CCCSLP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MED CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 FOREST DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520
Mailing Address - Country:US
Mailing Address - Phone:508-829-5460
Mailing Address - Fax:
Practice Address - Street 1:243 MILLBURY STREET
Practice Address - Street 2:PERNET FAMILY HEALTH AND SOCIAL SERVICE
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602
Practice Address - Country:US
Practice Address - Phone:508-795-0881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1313235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist