Provider Demographics
NPI:1447521133
Name:FRICKA, KAREN CORCORAN (MA, CCC/SLP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:CORCORAN
Last Name:FRICKA
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9051 TOWER HOUSE PL
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22308-2758
Mailing Address - Country:US
Mailing Address - Phone:703-780-2934
Mailing Address - Fax:
Practice Address - Street 1:9051 TOWER HOUSE PL
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22308-2758
Practice Address - Country:US
Practice Address - Phone:703-780-2934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003098235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist