MEDICARE: MRS. KAREN ST. CLAIR CCC-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	6243	NC

General Provider Information

NPI Number	:	1720129257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN ST. CLAIR CCC-SLP

Provider Business Mailing Address
First Line	:	8812 NEW HOPE FARM RD
Second Line	:
City	:	NEW HILL
State	:	NC
Zip	:	27562-9178
Country	:	US
Telephone Number	:	919-395-9812
Fax Number	:	919-303-9725

Provider Business Practice Location Address
First Line	:	8812 NEW HOPE FARM RD
Second Line	:
City	:	NEW HILL
State	:	NC
Zip	:	27562-9178
Country	:	US
Telephone Number	:	919-395-9812
Fax Number	:	919-303-9725

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

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	07/08/2007

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