Provider Demographics
NPI:1851417182
Name:LIPS, KAREN CHARLOTTE (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:CHARLOTTE
Last Name:LIPS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9903 JULLIARD DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1739
Mailing Address - Country:US
Mailing Address - Phone:301-509-8739
Mailing Address - Fax:
Practice Address - Street 1:9903 JULLIARD DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1739
Practice Address - Country:US
Practice Address - Phone:301-509-8739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14264174400000X
DCPT871218174400000X
CAPT14264174400000X
MD15692174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist