Provider Demographics
NPI:1336784230
Name:KARANIKAS, KRISTEN SARA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:SARA
Last Name:KARANIKAS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 WHISPERING FOREST DR APT 304
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-1339
Mailing Address - Country:US
Mailing Address - Phone:610-639-1255
Mailing Address - Fax:
Practice Address - Street 1:125 W BROAD ST
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-5257
Practice Address - Country:US
Practice Address - Phone:704-775-4466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12938225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist