Basic Information
| Provider Information | |||||||||
| NPI: | 1104081058 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MALOVRH | ||||||||
| FirstName: | KAREN | ||||||||
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| Credential: | M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 15TH AVE | ||||||||
| Address2: | #180 | ||||||||
| City: | SOUTH MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 531721160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4147685430 | ||||||||
| FaxNumber: | 4147624225 | ||||||||
| Practice Location | |||||||||
| Address1: | 10520 NORTH PORT WASHINGTON RD | ||||||||
| Address2: | |||||||||
| City: | MEQUON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530925537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2622400705 | ||||||||
| FaxNumber: | 2622400759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2008 | ||||||||
| LastUpdateDate: | 04/15/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | 29-156 | WI | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.