Provider Demographics
NPI:1831563634
Name:MAZZAFERRI, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MAZZAFERRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6870 FLOWER ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-1739
Mailing Address - Country:US
Mailing Address - Phone:775-830-8440
Mailing Address - Fax:
Practice Address - Street 1:6870 FLOWER ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-1739
Practice Address - Country:US
Practice Address - Phone:775-830-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 60588845235Z00000X
ARSP 3727235Z00000X
NVSP 1243235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist