Doctor Name: | MS. KAROLYN JUNE MACK |
NPI Number: | 1972587236 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S./C.C.C.-SLP |
License Number: | 2202004006 |
Business Practice Address: | 209 W Criser Rd Front Royal, VA - 226302360 |
Business Phone Number: | 5406362931 |
Business Fax Number: | 5406368161 |
Mailing Address: | 1315 Lakeview Dr, CROSS JUNCTION |
State: | VA |
Postal Code: | 226252517 |
Phone Number: | 5402472323 |
Fax Number: | 5404502707 |
NPI Enumeration Date: | 11/30/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202004006 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |