Provider Demographics
NPI:1881050656
Name:DAVIS, KAREN M (MS)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:M
Other - Last Name:COUTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:116 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2318
Mailing Address - Country:US
Mailing Address - Phone:267-607-3959
Mailing Address - Fax:
Practice Address - Street 1:1 FITZWATERTOWN RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-3028
Practice Address - Country:US
Practice Address - Phone:267-607-3959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2017-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health