Provider Demographics
NPI:1356088959
Name:DAYHOFF NESBITT, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DAYHOFF NESBITT
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 1:291 N MUD CREEK RD
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MT
Mailing Address - Zip Code:59917-9734
Mailing Address - Country:US
Mailing Address - Phone:808-756-1510
Mailing Address - Fax:
Practice Address - Street 1:291 N MUD CREEK RD
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917-9734
Practice Address - Country:US
Practice Address - Phone:808-756-1510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT45061103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool