Provider Demographics
NPI:1194297762
Name:LEE, KARINA STEPHANIE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:STEPHANIE
Last Name:LEE
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 1:9858 CLINT MOORE RD STE C111-207
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-1034
Mailing Address - Country:US
Mailing Address - Phone:561-203-5383
Mailing Address - Fax:
Practice Address - Street 1:9858 CLINT MOORE RD STE C111-207
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-1034
Practice Address - Country:US
Practice Address - Phone:561-203-5383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-20
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA19343235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist