Provider Demographics
NPI:1316262116
Name:GOUGER, KARYN ANN (MS/CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:KARYN
Middle Name:ANN
Last Name:GOUGER
Suffix:
Gender:F
Credentials:MS/CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 WEBER RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-7757
Mailing Address - Country:US
Mailing Address - Phone:570-296-5026
Mailing Address - Fax:
Practice Address - Street 1:404 E HARFORD ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-1028
Practice Address - Country:US
Practice Address - Phone:570-409-9191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007260235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist