Provider Demographics
NPI:1235699018
Name:HENERY, KAREN A (LMT, CPS)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:HENERY
Suffix:
Gender:F
Credentials:LMT, CPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 RIVERVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BLAWNOX
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2735
Mailing Address - Country:US
Mailing Address - Phone:412-420-9029
Mailing Address - Fax:
Practice Address - Street 1:1360 OLD FREEPORT RD STE 1A
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-4102
Practice Address - Country:US
Practice Address - Phone:412-772-1461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG010952225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist