Provider Demographics
NPI:1497173330
Name:AWWAD, KAREN (MHSA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:AWWAD
Suffix:
Gender:F
Credentials:MHSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13306 FINSBURY CT APT 2
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1531
Mailing Address - Country:US
Mailing Address - Phone:301-331-6050
Mailing Address - Fax:240-764-6764
Practice Address - Street 1:13306 FINSBURY CT APT 2
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1531
Practice Address - Country:US
Practice Address - Phone:301-331-6050
Practice Address - Fax:240-764-6764
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist