=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760937361
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MOLLI KAREN M.S.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2016
-----------------------------------------------------
Last Update Date | 05/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6015 MOUNT RUSHMORE RD STE 3
-----------------------------------------------------
City | RAPID CITY
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57701-8984
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-443-6164
-----------------------------------------------------
Fax | 605-412-8021
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 45 GLENSHIRE DR
-----------------------------------------------------
City | RAPID CITY
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57701-7705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-431-6659
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 605-SLP
-----------------------------------------------------
License Number State | SD
-----------------------------------------------------