Provider Demographics
NPI:1205870235
Name:BROWN, KAREN T (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:T
Last Name:BROWN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 VINEYARD DR
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06037-1842
Mailing Address - Country:US
Mailing Address - Phone:860-919-1098
Mailing Address - Fax:
Practice Address - Street 1:150 VINEYARD DR
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:CT
Practice Address - Zip Code:06037-1842
Practice Address - Country:US
Practice Address - Phone:860-919-1098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003309235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT9648226Medicare UPIN
CT660003309CT02Medicare UPIN