Provider Demographics
NPI:1699275958
Name:DUDA, KAREN BORRELLO
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:BORRELLO
Last Name:DUDA
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 1:430 E SHIRLEY AVE STE B8
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3725
Mailing Address - Country:US
Mailing Address - Phone:540-422-7142
Mailing Address - Fax:
Practice Address - Street 1:430 E SHIRLEY AVE STE B8
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3725
Practice Address - Country:US
Practice Address - Phone:540-422-7142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2203000635235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist