Provider Demographics
NPI:1871722488
Name:SCHUCHMANN, KARLA KENNERLEY (SLP)
Entity type:Individual
Prefix:MS
First Name:KARLA
Middle Name:KENNERLEY
Last Name:SCHUCHMANN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4385 BRANDYWINE DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34241-6108
Mailing Address - Country:US
Mailing Address - Phone:941-379-7785
Mailing Address - Fax:
Practice Address - Street 1:502 5TH AVENUE DR E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-2006
Practice Address - Country:US
Practice Address - Phone:941-747-5847
Practice Address - Fax:941-747-4865
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6719235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist