Provider Demographics
NPI:1205277472
Name:COONEY, KAREN L (MA, CHHC)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:L
Last Name:COONEY
Suffix:
Gender:F
Credentials:MA, CHHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 PARKSIDE LN
Mailing Address - Street 2:
Mailing Address - City:WEST CREEK
Mailing Address - State:NJ
Mailing Address - Zip Code:08092-2832
Mailing Address - Country:US
Mailing Address - Phone:609-548-9029
Mailing Address - Fax:609-597-7020
Practice Address - Street 1:105 PARKSIDE LN
Practice Address - Street 2:
Practice Address - City:WEST CREEK
Practice Address - State:NJ
Practice Address - Zip Code:08092-2832
Practice Address - Country:US
Practice Address - Phone:609-548-9029
Practice Address - Fax:609-597-7020
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1681250133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist