MEDICARE: MRS. KAREN KAPLAN WEISS MACCC-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	01023708	CO

General Provider Information

NPI Number	:	1073740031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN KAPLAN WEISS MACCC-SLP

Provider Business Mailing Address
First Line	:	1090 GOLDEN HILLS RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-7910
Country	:	US
Telephone Number	:	719-598-4217
Fax Number	:

Provider Business Practice Location Address
First Line	:	1090 GOLDEN HILLS RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-7910
Country	:	US
Telephone Number	:	719-598-4217
Fax Number	:

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

Provider Enumeration Date	:	06/17/2009
Last Update Date	:	06/17/2009

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