MEDICARE: LYDIA ROSE KARBUM

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	SLP.0003747	CO

General Provider Information

NPI Number	:	1689220931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYDIA ROSE KARBUM

Provider Business Mailing Address
First Line	:	4385 COMANCHE DR APT 1
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80303-3670
Country	:	US
Telephone Number	:	248-860-5035
Fax Number	:

Provider Business Practice Location Address
First Line	:	4385 COMANCHE DR APT 1
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80303-3670
Country	:	US
Telephone Number	:	248-860-5035
Fax Number	:

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

Provider Enumeration Date	:	08/13/2019
Last Update Date	:	04/08/2026

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Directions to “ LYDIA ROSE KARBUM ” Practice Location

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