Provider Demographics
NPI:1831923994
Name:OZIMKIEWICZ, KARA MARIE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:MARIE
Last Name:OZIMKIEWICZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14551 NEEDHAM DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0874
Mailing Address - Country:US
Mailing Address - Phone:267-337-4917
Mailing Address - Fax:
Practice Address - Street 1:12627 SAN JOSE BLVD STE 803
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8644
Practice Address - Country:US
Practice Address - Phone:904-834-1336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA20484235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist