Provider Demographics
NPI:1881178143
Name:DIEFENDERFER, KARA A (MS)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:A
Last Name:DIEFENDERFER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7515 TENDER HEART CIR
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-6703
Mailing Address - Country:US
Mailing Address - Phone:484-223-5463
Mailing Address - Fax:484-229-9189
Practice Address - Street 1:7515 TENDER HEART CIR
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-6703
Practice Address - Country:US
Practice Address - Phone:484-223-5463
Practice Address - Fax:484-229-9189
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2023-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor