Provider Demographics
NPI:1427326313
Name:CHASE, KARIN L
Entity type:Individual
Prefix:MRS
First Name:KARIN
Middle Name:L
Last Name:CHASE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3742 BIRCH RUN RD
Mailing Address - Street 2:
Mailing Address - City:ALLEGANY
Mailing Address - State:NY
Mailing Address - Zip Code:14706-9501
Mailing Address - Country:US
Mailing Address - Phone:716-373-5655
Mailing Address - Fax:
Practice Address - Street 1:WASHINGTON STREET
Practice Address - Street 2:SCIO CENTRAL SCHOOL, KARIN CHASE
Practice Address - City:SCIO
Practice Address - State:NY
Practice Address - Zip Code:14880
Practice Address - Country:US
Practice Address - Phone:585-593-5510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012268-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY012268-1OtherNEW YORK STATE LICENSED SPEECH LANGUAGE PATHOLOGIST