Provider Demographics
NPI:1295206274
Name:CAMP, KARYNN
Entity type:Individual
Prefix:
First Name:KARYNN
Middle Name:
Last Name:CAMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 W 2000 S APT 103C
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-0258
Mailing Address - Country:US
Mailing Address - Phone:385-298-6737
Mailing Address - Fax:
Practice Address - Street 1:2811 N 2350 W
Practice Address - Street 2:
Practice Address - City:FARR WEST
Practice Address - State:UT
Practice Address - Zip Code:84404-5177
Practice Address - Country:US
Practice Address - Phone:801-872-8757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty