Provider Demographics
NPI:1538581566
Name:OSORIO, KAREN S (MS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:OSORIO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 LEE ROAD 998
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36870-9175
Mailing Address - Country:US
Mailing Address - Phone:334-332-6265
Mailing Address - Fax:
Practice Address - Street 1:2515 DOUBLE CHURCHES RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-2742
Practice Address - Country:US
Practice Address - Phone:706-660-5495
Practice Address - Fax:706-660-5497
Is Sole Proprietor?:No
Enumeration Date:2014-01-10
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP008424235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist