Provider Demographics
NPI:1982824942
Name:RUBIN, KAREN LISA (MACCC, SLP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LISA
Last Name:RUBIN
Suffix:
Gender:F
Credentials:MACCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 CHARTER ST
Mailing Address - Street 2:APT # 3F
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02113-1126
Mailing Address - Country:US
Mailing Address - Phone:781-593-2727
Mailing Address - Fax:781-593-2542
Practice Address - Street 1:103 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-4001
Practice Address - Country:US
Practice Address - Phone:781-593-2727
Practice Address - Fax:781-593-2542
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4726235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist