Provider Demographics
NPI:1740328954
Name:JENNINGS, KAREN TUBBS (MS, CCC-A)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:TUBBS
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 CENTERBROOK PL
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-1451
Mailing Address - Country:US
Mailing Address - Phone:512-524-0434
Mailing Address - Fax:
Practice Address - Street 1:7200 WYOMING SPGS
Practice Address - Street 2:SUITE 1200
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4303
Practice Address - Country:US
Practice Address - Phone:512-388-2217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51205231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist