Provider Demographics
NPI:1013134535
Name:HASWELL, KAREN LOIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LOIS
Last Name:HASWELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:HASWELL
Other - Last Name:FENTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:309 WENDOVER AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3000
Mailing Address - Country:US
Mailing Address - Phone:502-895-8353
Mailing Address - Fax:502-895-8222
Practice Address - Street 1:309 WENDOVER AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3000
Practice Address - Country:US
Practice Address - Phone:502-895-8353
Practice Address - Fax:502-895-8222
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY401103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical