1194938993 NPI number — MISS KARI B. COMER SLP

Table of content: MISS KARI B. COMER SLP (NPI 1194938993)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194938993 NPI number — MISS KARI B. COMER SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COMER
Provider First Name:
KARI
Provider Middle Name:
B.
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194938993
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
04/02/2012
NPI Reactivation Date:
10/04/2018

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8203 PARKVIEW LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALPHARETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30005-5407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-789-7089
Provider Business Mailing Address Fax Number:
770-645-1313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11111 HOUZE RD STE 101
Provider Second Line Business Practice Location Address:
COBBLESTONE THERAPY GROUP
Provider Business Practice Location Address City Name:
ROSWELL
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30076-1464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-998-9599
Provider Business Practice Location Address Fax Number:
770-645-1313
Provider Enumeration Date:
05/08/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SLP006533 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)