Basic Information
| Provider Information | |||||||||
| NPI: | 1982824942 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUBIN | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | LISA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.A.CCC, SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 71 CHARTER ST | ||||||||
| Address2: | APT # 3F | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021131126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7815932727 | ||||||||
| FaxNumber: | 7815932542 | ||||||||
| Practice Location | |||||||||
| Address1: | 103 JOHNSON ST | ||||||||
| Address2: | |||||||||
| City: | LYNN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019024001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7815932727 | ||||||||
| FaxNumber: | 7815932542 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 4726 | MA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.