Provider Demographics
NPI:1538445986
Name:MCLENNAN, KAREN LIEBL (MS CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LIEBL
Last Name:MCLENNAN
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10251 SOURDOUGH RD
Mailing Address - Street 2:
Mailing Address - City:BELLE FOURCHE
Mailing Address - State:SD
Mailing Address - Zip Code:57717-6168
Mailing Address - Country:US
Mailing Address - Phone:605-639-0262
Mailing Address - Fax:
Practice Address - Street 1:10251 SOURDOUGH RD
Practice Address - Street 2:
Practice Address - City:BELLE FOURCHE
Practice Address - State:SD
Practice Address - Zip Code:57717-6168
Practice Address - Country:US
Practice Address - Phone:605-639-0262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist