Provider Demographics
NPI:1982727301
Name:REISCHKE, KAREN SUE (MA CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SUE
Last Name:REISCHKE
Suffix:
Gender:F
Credentials:MA CCC-SLP/L
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:SUE
Other - Last Name:RICKARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 FREDERICK AVE
Mailing Address - Street 2:
Mailing Address - City:MARMORA
Mailing Address - State:NJ
Mailing Address - Zip Code:08223-1906
Mailing Address - Country:US
Mailing Address - Phone:610-639-6782
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:199 NEW RD STE 38
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-2025
Practice Address - Country:US
Practice Address - Phone:609-703-6741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2019-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005599L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist