Provider Demographics
NPI:1770714230
Name:GOODWIN, KAREN KLEINSTEIBER (MS, CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:KLEINSTEIBER
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23537 POCAHONTAS DR
Mailing Address - Street 2:
Mailing Address - City:LAYTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20882-3217
Mailing Address - Country:US
Mailing Address - Phone:301-305-8211
Mailing Address - Fax:
Practice Address - Street 1:23537 POCAHONTAS DR
Practice Address - Street 2:
Practice Address - City:LAYTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20882-3217
Practice Address - Country:US
Practice Address - Phone:301-305-8211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-01
Last Update Date:2009-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00966235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist