Provider Demographics
NPI:1790310845
Name:KARNAS, ALICJA M (IMH 19391)
Entity Type:Individual
Prefix:
First Name:ALICJA
Middle Name:M
Last Name:KARNAS
Suffix:
Gender:F
Credentials:IMH 19391
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 W. HIGHWAY 98
Mailing Address - Street 2:SUITE C TOWN CENTRE PLAZA
Mailing Address - City:PORT ST. JOE
Mailing Address - State:FL
Mailing Address - Zip Code:32456
Mailing Address - Country:US
Mailing Address - Phone:850-705-1766
Mailing Address - Fax:
Practice Address - Street 1:212 W. HIGHWAY 98
Practice Address - Street 2:SUITE C TOWN CENTRE PLAZA
Practice Address - City:PORT ST. JOE
Practice Address - State:FL
Practice Address - Zip Code:32456
Practice Address - Country:US
Practice Address - Phone:850-705-1766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health