Basic Information
| Provider Information | |||||||||
| NPI: | 1538581566 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OSORIO | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 44 LEE ROAD 998 | ||||||||
| Address2: | |||||||||
| City: | PHENIX CITY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 368709175 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3343326265 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2515 DOUBLE CHURCHES RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319092742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7066605495 | ||||||||
| FaxNumber: | 7066605497 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2014 | ||||||||
| LastUpdateDate: | 01/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SLP008424 | GA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.