Provider Demographics
NPI:1346975885
Name:POULSON, KARI MARIE (LPC-A)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:MARIE
Last Name:POULSON
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1252 MORAN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3150
Mailing Address - Country:US
Mailing Address - Phone:817-688-8359
Mailing Address - Fax:
Practice Address - Street 1:1252 MORAN DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3150
Practice Address - Country:US
Practice Address - Phone:817-688-8359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor