Provider Demographics
NPI:1811078124
Name:MUNOZ, KAREN FRANCES (EDD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:FRANCES
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 OLD MAIN HILL
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321
Mailing Address - Country:US
Mailing Address - Phone:435-797-3701
Mailing Address - Fax:
Practice Address - Street 1:2620 OLD MAIN HILL
Practice Address - Street 2:NORTHERN ILLINOIS UNIV SPEECH-LANGUAGE-HEARING CLINIC
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321
Practice Address - Country:US
Practice Address - Phone:435-797-3701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147000513231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT110100070Medicaid
ILKM7045698POtherEARLY INTERVENTION