Provider Demographics
NPI:1720534902
Name:REDDICK, KAREN (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:REDDICK
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 SE 24TH RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-6005
Mailing Address - Country:US
Mailing Address - Phone:352-629-8900
Mailing Address - Fax:
Practice Address - Street 1:1501 SE 24TH RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-6005
Practice Address - Country:US
Practice Address - Phone:352-629-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 7738390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program