Provider Demographics
NPI:1427327337
Name:TRAVER, KAREN (MA, CCC, SLP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:TRAVER
Suffix:
Gender:F
Credentials:MA, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 MERLE AVE
Mailing Address - Street 2:OCEANSIDE PUBLIC SCHOOLS
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2219
Mailing Address - Country:US
Mailing Address - Phone:718-594-2345
Mailing Address - Fax:
Practice Address - Street 1:145 MERLE AVE
Practice Address - Street 2:OCEANSIDE PUBLIC SCHOOLS
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2219
Practice Address - Country:US
Practice Address - Phone:516-594-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58 005200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist