Provider Demographics
NPI:1871633834
Name:FORSYTH, KARYN M (PHD)
Entity Type:Individual
Prefix:DR
First Name:KARYN
Middle Name:M
Last Name:FORSYTH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 HASKELL ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-2815
Mailing Address - Country:US
Mailing Address - Phone:775-348-8558
Mailing Address - Fax:
Practice Address - Street 1:1065 HASKELL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-2815
Practice Address - Country:US
Practice Address - Phone:775-348-8558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV429103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV36394Medicare ID - Type Unspecified