Provider Demographics
NPI:1740495357
Name:EDWARDS, KAREN S (SLP)
Entity type:Individual
Prefix:MR
First Name:KAREN
Middle Name:S
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 KENWOOD DRIVE
Mailing Address - Street 2:PO BOX 143
Mailing Address - City:LA CENTER
Mailing Address - State:KY
Mailing Address - Zip Code:42056-0143
Mailing Address - Country:US
Mailing Address - Phone:270-665-5681
Mailing Address - Fax:270-665-5875
Practice Address - Street 1:252 W. 5TH STREET
Practice Address - Street 2:
Practice Address - City:LA CENTER
Practice Address - State:KY
Practice Address - Zip Code:42056
Practice Address - Country:US
Practice Address - Phone:270-665-5681
Practice Address - Fax:270-665-5875
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0688235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist