Provider Demographics
NPI:1508506965
Name:WAY, KARINE (LBS)
Entity Type:Individual
Prefix:
First Name:KARINE
Middle Name:
Last Name:WAY
Suffix:
Gender:F
Credentials:LBS
Other - Prefix:
Other - First Name:KARINE
Other - Middle Name:
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:998 OLD EAGLE SCHOOL RD STE 126
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:998 OLD EAGLE SCHOOL RD STE 1206
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1805
Practice Address - Country:US
Practice Address - Phone:215-941-9098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor