Provider Demographics
NPI:1174741623
Name:DEMOSS, KAREN L (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:L
Last Name:DEMOSS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 SHAKER DR
Mailing Address - Street 2:SUITE 128
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3662
Mailing Address - Country:US
Mailing Address - Phone:859-277-2547
Mailing Address - Fax:859-277-2926
Practice Address - Street 1:715 SHAKER DR
Practice Address - Street 2:SUITE 128
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3662
Practice Address - Country:US
Practice Address - Phone:859-277-2547
Practice Address - Fax:859-277-2926
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0824103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist