Provider Demographics
NPI:1932448503
Name:STONE, KAREN A (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:STONE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4841 DECATUR CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-7295
Mailing Address - Country:US
Mailing Address - Phone:321-258-5924
Mailing Address - Fax:
Practice Address - Street 1:4841 DECATUR CIR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32934-7295
Practice Address - Country:US
Practice Address - Phone:321-258-5924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-02
Last Update Date:2013-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 1649235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist