Provider Demographics
NPI:1871970442
Name:MOBLEY, KAREN (AUD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 SUNBROOK WAY NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-8030
Mailing Address - Country:US
Mailing Address - Phone:404-427-4006
Mailing Address - Fax:
Practice Address - Street 1:5004 SUNBROOK WAY NW
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-8030
Practice Address - Country:US
Practice Address - Phone:404-427-4006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-02
Last Update Date:2015-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003422231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist