Provider Demographics
NPI:1669420147
Name:SENIOR, KAREN VIRGINIA (EDS, CCC/SP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:VIRGINIA
Last Name:SENIOR
Suffix:
Gender:F
Credentials:EDS, CCC/SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1392 MACON DR
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-8341
Mailing Address - Country:US
Mailing Address - Phone:803-531-9958
Mailing Address - Fax:803-531-9958
Practice Address - Street 1:1392 MACON DR
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-8341
Practice Address - Country:US
Practice Address - Phone:803-531-9958
Practice Address - Fax:803-531-9958
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2322235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA0322Medicaid