Provider Demographics
NPI:1154771103
Name:STOREY, KARYN K (AUD)
Entity type:Individual
Prefix:
First Name:KARYN
Middle Name:K
Last Name:STOREY
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 1:5872 S 900 E STE 175
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-1673
Mailing Address - Country:US
Mailing Address - Phone:801-268-3277
Mailing Address - Fax:801-268-3288
Practice Address - Street 1:5872 S 900 E STE 175
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-1673
Practice Address - Country:US
Practice Address - Phone:801-268-3277
Practice Address - Fax:801-268-3288
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9826722-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist