Crockett, Karen E

Crockett, Karen E is an sole proprietor health care provider with primary practice located at 2914 Busch Lake Blvd , Tampa FL 33614-1859. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Crockett, Karen E can be contacted via phone (813) 933-0455.

Contact Information

Primary practice address
2914 Busch Lake Blvd Tampa FL 33614-1859
Phone: (813) 933-0455
Fax: (813) 933-0457
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA 774 Florida

Profile Details

NPI number 1770570509
LBN Legal business name Crockett, Karen E
Credentials PH.D., CCC-SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 6th, 2005
Last updated Jun 18th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770570509 NPPES
Florida MEDICAID 880439700

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