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General NPI Number Information
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NPI Number | 1891459590
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Entity Type | Individual
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Provider Name | KARINA STEPANOVA CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/28/2021
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 2120 MAE DELL RD
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2455
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Country | US
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Telephone | 423-622-1551
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9209
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City | GALLATIN
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State | TN
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Zip | 37066-6925
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Country | US
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Telephone | 347-482-9292
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 031315
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 07817
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License Number State | TN
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