Provider Demographics
NPI:1740667120
Name:BROWN, KAREN HARRIS (PHD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:HARRIS
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8782
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-1782
Mailing Address - Country:US
Mailing Address - Phone:404-797-1004
Mailing Address - Fax:
Practice Address - Street 1:56 CARET BAY
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-1782
Practice Address - Country:US
Practice Address - Phone:404-797-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-05
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP 003504235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist