Healthcare Provider Details

I. General information

NPI: 1508309279
Provider Name (Legal Business Name): KARA AMEDEI EPPERT MS CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2016
Last Update Date: 01/31/2023
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 S HAMILTON RD
GAHANNA OH
43230-2919
US

IV. Provider business mailing address

160 S HAMILTON RD
GAHANNA OH
43230-2919
US

V. Phone/Fax

Practice location:
  • Phone: 614-471-7065
  • Fax:
Mailing address:
  • Phone: 614-269-4718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberOH3252586
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP. 12217
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: