Provider Demographics
NPI:1336490002
Name:IRWIN, KARI
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:IRWIN
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 1:11175 GEORGIA AVE
Mailing Address - Street 2:APT #238
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902
Mailing Address - Country:US
Mailing Address - Phone:505-239-1204
Mailing Address - Fax:
Practice Address - Street 1:11175 GEORGIA AVE
Practice Address - Street 2:APT #238
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902
Practice Address - Country:US
Practice Address - Phone:505-239-1204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst