Provider Demographics
NPI:1649435736
Name:HAIRE, KAREN MARIE
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:MARIE
Last Name:HAIRE
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 1:17409 SUMMER OAK LN
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5905
Mailing Address - Country:US
Mailing Address - Phone:407-654-3000
Mailing Address - Fax:407-905-8958
Practice Address - Street 1:1002 S DILLARD ST
Practice Address - Street 2:SUITE 106
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3991
Practice Address - Country:US
Practice Address - Phone:407-905-8908
Practice Address - Fax:407-905-8958
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13211225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist