Karen K. Robertson, M.S., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Staunton, IL

NPI 1619253150 · NPPES record last updated Oct 28, 2011

Key facts

NPI
1619253150
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
146004584 (IL)
Practice address
204 E Leonard St
Staunton, IL 62088-1229
Phone
(613) 635-2793
Fax
(618) 635-4637
NPI assigned
Oct 28, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
146004584ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146004584 IL Yes

Addresses

Primary practice location

204 E Leonard St
Staunton, IL 62088-1229

Mailing address

204 E Leonard St
Staunton, IL 62088-1229
Phone (613) 635-2793

Other providers in Staunton, IL

All providers in Staunton, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.