Provider Demographics
NPI:1962770537
Name:UNTERBUG, KARYN PETERS (CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:KARYN
Middle Name:PETERS
Last Name:UNTERBUG
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:MISS
Other - First Name:KARYN
Other - Middle Name:ALICIA
Other - Last Name:UNTERBUG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP-A
Mailing Address - Street 1:4052 BRAZOS DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-1134
Mailing Address - Country:US
Mailing Address - Phone:214-529-8177
Mailing Address - Fax:
Practice Address - Street 1:3755 WALNUT HILL LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-6100
Practice Address - Country:US
Practice Address - Phone:214-902-0996
Practice Address - Fax:214-350-3439
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24988235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist