Provider Demographics
NPI:1144660655
Name:EDWARDS, KAREN LENORE (PH/D/)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LENORE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PH/D/
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6404 THORNBERRY CT
Mailing Address - Street 2:SUITE 430
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-3502
Mailing Address - Country:US
Mailing Address - Phone:513-229-7585
Mailing Address - Fax:513-229-7731
Practice Address - Street 1:6404 THORNBERRY CT
Practice Address - Street 2:SUITE 430
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-3502
Practice Address - Country:US
Practice Address - Phone:513-229-7585
Practice Address - Fax:513-229-7731
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3292103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist