Provider Demographics
NPI:1487737540
Name:BUTCHART, KAREN LYNN (BC-HIS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:BUTCHART
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8023 GRAND RIVER RD
Mailing Address - Street 2:400
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-9392
Mailing Address - Country:US
Mailing Address - Phone:810-494-4327
Mailing Address - Fax:810-494-4329
Practice Address - Street 1:8023 GRAND RIVER RD
Practice Address - Street 2:400
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-9392
Practice Address - Country:US
Practice Address - Phone:810-494-4327
Practice Address - Fax:810-494-4329
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501001767237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4285400Medicaid