Provider Demographics
NPI:1083475248
Name:STOCKAR, KARYN (MS, NBC-HWC)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:
Last Name:STOCKAR
Suffix:
Gender:F
Credentials:MS, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 CAMBERWELL RD
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19311-1359
Mailing Address - Country:US
Mailing Address - Phone:302-545-2975
Mailing Address - Fax:
Practice Address - Street 1:100 DISCOVERY BLVD FL 2
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-1325
Practice Address - Country:US
Practice Address - Phone:302-831-3891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA-3787319171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach