Provider Demographics
NPI:1467839449
Name:KERNS, KAREN MARIE (BCPP, RCST, LMT)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:MARIE
Last Name:KERNS
Suffix:
Gender:F
Credentials:BCPP, RCST, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 PAULINE BLVD.
Mailing Address - Street 2:SUITE 300B
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-5047
Mailing Address - Country:US
Mailing Address - Phone:734-347-0532
Mailing Address - Fax:
Practice Address - Street 1:1955 PAULINE BLVD.
Practice Address - Street 2:SUITE 300B
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-5047
Practice Address - Country:US
Practice Address - Phone:734-347-0532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL423959225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist