Provider Demographics
NPI:1407036304
Name:CONNELL, KAREN WYLIE (OTR, ATP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:WYLIE
Last Name:CONNELL
Suffix:
Gender:F
Credentials:OTR, ATP
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Mailing Address - Street 1:3514 OAKDALE DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-2350
Mailing Address - Country:US
Mailing Address - Phone:254-770-0591
Mailing Address - Fax:254-770-0591
Practice Address - Street 1:3514 OAKDALE DR
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-2350
Practice Address - Country:US
Practice Address - Phone:254-770-0591
Practice Address - Fax:254-770-0591
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX101275225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist