Provider Demographics
NPI:1609400787
Name:ALSTON, KAREN L (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:ALSTON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 CLERMONT CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-1990
Mailing Address - Country:US
Mailing Address - Phone:513-735-8300
Mailing Address - Fax:
Practice Address - Street 1:4286 WUEBOLD LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1841
Practice Address - Country:US
Practice Address - Phone:513-732-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP13355235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist