Provider Demographics
NPI:1043634371
Name:JARA, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:JARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8471 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-4701
Mailing Address - Country:US
Mailing Address - Phone:513-474-3811
Mailing Address - Fax:513-474-7225
Practice Address - Street 1:8471 FOREST RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4701
Practice Address - Country:US
Practice Address - Phone:513-474-3811
Practice Address - Fax:513-474-7225
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool