Provider Demographics
NPI:1376730226
Name:TANNER, KAREN L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:L
Last Name:TANNER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 N DUPONT HWY
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-1160
Mailing Address - Country:US
Mailing Address - Phone:302-255-2934
Mailing Address - Fax:302-255-4478
Practice Address - Street 1:1901 N DUPONT HWY
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-1160
Practice Address - Country:US
Practice Address - Phone:302-255-2934
Practice Address - Fax:302-255-4478
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000705103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical