Provider Demographics
NPI:1780812503
Name:RICHARDSON, KAREN JANINE (AUD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:JANINE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 GOLFVIEW CIR NE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4302
Mailing Address - Country:US
Mailing Address - Phone:863-258-2548
Mailing Address - Fax:
Practice Address - Street 1:9912 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-3419
Practice Address - Country:US
Practice Address - Phone:727-869-4100
Practice Address - Fax:727-869-4148
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY638231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist