Provider Demographics
NPI:1396772695
Name:DEDINSKY, KAREN J (SLP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:DEDINSKY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:996 HOWARD DR
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-1634
Mailing Address - Country:US
Mailing Address - Phone:330-633-7899
Mailing Address - Fax:
Practice Address - Street 1:2500 BRADY LAKE RD
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-1610
Practice Address - Country:US
Practice Address - Phone:330-678-2400
Practice Address - Fax:330-673-3714
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP0342235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist