Provider Demographics
NPI:1629779970
Name:BURNS, KARENA NICOLE (COTA/L)
Entity Type:Individual
Prefix:
First Name:KARENA
Middle Name:NICOLE
Last Name:BURNS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:KARENA
Other - Middle Name:NICOLE
Other - Last Name:JOYNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:1609 HAVEN PL
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-4610
Mailing Address - Country:US
Mailing Address - Phone:214-392-2853
Mailing Address - Fax:
Practice Address - Street 1:382 E 400 S
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-1991
Practice Address - Country:US
Practice Address - Phone:801-703-5360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12160804-4202224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant