Provider Demographics
NPI:1275511602
Name:KARKOSH, BETTY J (MA)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:J
Last Name:KARKOSH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-9462
Mailing Address - Country:US
Mailing Address - Phone:563-264-3191
Mailing Address - Fax:563-262-0415
Practice Address - Street 1:2821 HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-9462
Practice Address - Country:US
Practice Address - Phone:563-264-3191
Practice Address - Fax:563-262-0415
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00104101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional