Provider Demographics
NPI:1437210028
Name:RATHGE, KAREN MAUREEN (MA MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:MAUREEN
Last Name:RATHGE
Suffix:
Gender:F
Credentials:MA 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 1:9105 LAGRIMA DE ORO RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2446
Mailing Address - Country:US
Mailing Address - Phone:505-296-5409
Mailing Address - Fax:
Practice Address - Street 1:9105 LAGRIMA DE ORO RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2446
Practice Address - Country:US
Practice Address - Phone:505-296-5409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM208235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist