Provider Demographics
NPI:1992822969
Name:NUTT, KAREN MARIE (BA)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:MARIE
Last Name:NUTT
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1698 MURAL DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3247
Mailing Address - Country:US
Mailing Address - Phone:626-859-2089
Mailing Address - Fax:626-859-6537
Practice Address - Street 1:4740 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-2005
Practice Address - Country:US
Practice Address - Phone:626-859-2089
Practice Address - Fax:626-859-6537
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker