Provider Demographics
NPI:1407955750
Name:DANIELS, KAREN F (LMT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:F
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:F
Other - Last Name:GUARDENIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:PO BOX 1255
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-1255
Mailing Address - Country:US
Mailing Address - Phone:928-639-4726
Mailing Address - Fax:
Practice Address - Street 1:788 S JEROME VWS
Practice Address - Street 2:
Practice Address - City:CORNVILLE
Practice Address - State:AZ
Practice Address - Zip Code:86325-4823
Practice Address - Country:US
Practice Address - Phone:928-639-4726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-01939174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist