Healthcare Provider Details

I. General information

NPI: 1992793152
Provider Name (Legal Business Name): LAURA A. KARCHER M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S JORDAN AVE
BLOOMINGTON IN
47405-7002
US

IV. Provider business mailing address

2555 E NOTTINGHAM CT
BLOOMINGTON IN
47401-8356
US

V. Phone/Fax

Practice location:
  • Phone: 812-855-6251
  • Fax:
Mailing address:
  • Phone: 812-824-4097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22002323A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: