Provider Demographics
NPI:1407170848
Name:WERT, KAREN MICHELE (MA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:MICHELE
Last Name:WERT
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 ALLENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-6183
Mailing Address - Country:US
Mailing Address - Phone:717-712-7998
Mailing Address - Fax:
Practice Address - Street 1:848 ALLENVIEW DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6183
Practice Address - Country:US
Practice Address - Phone:717-712-7998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-05-2472103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst