Provider Demographics
NPI:1972054658
Name:TREMBLE, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:TREMBLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:WELCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:74 BLAIRS HILL RD
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-2289
Mailing Address - Country:US
Mailing Address - Phone:339-225-1847
Mailing Address - Fax:
Practice Address - Street 1:74 BLAIRS HILL RD
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-2289
Practice Address - Country:US
Practice Address - Phone:339-225-1847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8792235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist