MEDICARE: MRS. KARI A MASON SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	22003959A	IN

General Provider Information

NPI Number	:	1306802939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARI A MASON SLP

Provider Business Mailing Address
First Line	:	10305 DAWSONS CREEK BLVD
Second Line	:	STE F
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-1914
Country	:	US
Telephone Number	:	260-497-0328
Fax Number	:	260-497-0904

Provider Business Practice Location Address
First Line	:	10305 DAWSONS CREEK BLVD
Second Line	:	STE F
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-1914
Country	:	US
Telephone Number	:	260-497-0328
Fax Number	:	260-497-0904

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2006
Last Update Date	:	07/08/2007

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Directions to “ MRS. KARI A MASON SLP” Practice Location

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