Provider Demographics
NPI:1689848822
Name:MOORE, KAREN MARIE (AUD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:MOORE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
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Mailing Address - Street 1:2295 HENRY TECKLENBURG DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-7801
Mailing Address - Country:US
Mailing Address - Phone:843-766-7103
Mailing Address - Fax:843-402-6840
Practice Address - Street 1:1849 SAVAGE RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4726
Practice Address - Country:US
Practice Address - Phone:843-766-7103
Practice Address - Fax:843-402-6840
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC2084237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ357445449Medicare PIN