Provider Demographics
NPI:1336446327
Name:HAZEN, KAREN DIANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:DIANE
Last Name:HAZEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 CHATHAM SQ PARK STE 102
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-2585
Mailing Address - Country:US
Mailing Address - Phone:540-373-9577
Mailing Address - Fax:540-373-6266
Practice Address - Street 1:406 CHATHAM SQ PARK STE 102
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2585
Practice Address - Country:US
Practice Address - Phone:540-373-9577
Practice Address - Fax:540-373-6266
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004864101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor