Provider Demographics
NPI:1588984686
Name:DICKERSON, KAREN WALDROP (PHD CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:WALDROP
Last Name:DICKERSON
Suffix:
Gender:F
Credentials:PHD CCC-SLP
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:WALDROP
Other - Last Name:DICKERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD CCC-SLP
Mailing Address - Street 1:11001 HAMMERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-1913
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11001 HAMMERLY BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-1913
Practice Address - Country:US
Practice Address - Phone:713-935-9088
Practice Address - Fax:713-935-9654
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16177235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist