Provider Demographics
NPI:1992952303
Name:BODDEN, KAREN ABBOTT (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ABBOTT
Last Name:BODDEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:PATRICIA
Other - Last Name:ABBOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:15820 ADDISON RD
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3549
Mailing Address - Country:US
Mailing Address - Phone:866-919-3240
Mailing Address - Fax:877-300-7394
Practice Address - Street 1:15820 ADDISON RD
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3549
Practice Address - Country:US
Practice Address - Phone:866-919-3240
Practice Address - Fax:877-300-7394
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102981235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist