Provider Demographics
NPI:1003285073
Name:DEFOE, KARYN ELIZABETH (LPC)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:ELIZABETH
Last Name:DEFOE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KARYN
Other - Middle Name:ELIZABETH
Other - Last Name:BATE-DEFOE, AGUILERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3405 VOIGHT PL
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2362
Mailing Address - Country:US
Mailing Address - Phone:989-890-7125
Mailing Address - Fax:
Practice Address - Street 1:2411 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-5824
Practice Address - Country:US
Practice Address - Phone:541-682-3608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health