Provider Demographics
NPI:1649570847
Name:GUILLON, KAREN J (SPECIAL ED TEACHER)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:J
Last Name:GUILLON
Suffix:
Gender:F
Credentials:SPECIAL ED TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3126 KING ST
Mailing Address - Street 2:
Mailing Address - City:ENDWELL
Mailing Address - State:NY
Mailing Address - Zip Code:13760-3334
Mailing Address - Country:US
Mailing Address - Phone:607-785-1096
Mailing Address - Fax:
Practice Address - Street 1:3126 KING ST
Practice Address - Street 2:
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-3334
Practice Address - Country:US
Practice Address - Phone:607-785-1096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY460240174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist