Provider Demographics
NPI:1134430754
Name:FITCH, KAREN MARIE (MS ,CCC, L SLP, TSHH)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:FITCH
Suffix:
Gender:F
Credentials:MS ,CCC, L SLP, TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6289 W QUAKER ST
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2643
Mailing Address - Country:US
Mailing Address - Phone:716-662-8540
Mailing Address - Fax:
Practice Address - Street 1:697 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LACKAWANNA
Practice Address - State:NY
Practice Address - Zip Code:14218-1500
Practice Address - Country:US
Practice Address - Phone:716-822-4781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006642235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist