Provider Demographics
NPI:1194877811
Name:SPEIER, KAREN RINARDO (PHD, MP)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:RINARDO
Last Name:SPEIER
Suffix:
Gender:F
Credentials:PHD, MP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 STEELE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-5742
Mailing Address - Country:US
Mailing Address - Phone:225-383-2100
Mailing Address - Fax:225-383-2108
Practice Address - Street 1:650 STEELE BOULEVARD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-5742
Practice Address - Country:US
Practice Address - Phone:225-383-2100
Practice Address - Fax:225-383-2108
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2012-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA504103G00000X, 103TC0700X, 103TC2200X
LAMP.0504103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5S485Medicare PIN