Provider Demographics
NPI:1134429871
Name:SRAJ, KARA SUZANNE (MA, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:KARA
Middle Name:SUZANNE
Last Name:SRAJ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ASPEN WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-9463
Mailing Address - Country:US
Mailing Address - Phone:937-626-3782
Mailing Address - Fax:
Practice Address - Street 1:5800 BURKHARDT RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:OH
Practice Address - Zip Code:45431-2932
Practice Address - Country:US
Practice Address - Phone:937-259-6625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
IL146.010430235Z00000X
OHSP.9737235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist