Provider Demographics
NPI:1952685661
Name:RADER, KAREN M (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:RADER
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 STEELE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8507
Mailing Address - Country:US
Mailing Address - Phone:256-658-0622
Mailing Address - Fax:256-772-8764
Practice Address - Street 1:100 JETPLEX BLVD SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35824-2216
Practice Address - Country:US
Practice Address - Phone:256-772-4400
Practice Address - Fax:256-772-4404
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-06-3109103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst