Provider Demographics
NPI:1760711196
Name:BEALE, KAREN MARIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:BEALE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3219 W CORIANDER DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-3669
Mailing Address - Country:US
Mailing Address - Phone:812-208-7072
Mailing Address - Fax:520-812-7867
Practice Address - Street 1:1550 E. RIVER RD.
Practice Address - Street 2:ATRIA COMPANA DEL RIO
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718
Practice Address - Country:US
Practice Address - Phone:520-445-4447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6296174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist