Doctor Name: | MRS. KAREN A NN PENTA |
NPI Number: | 1760524151 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | MALMHC1420 |
Business Practice Address: | 947 Route 6a Ste 11 Yarmouth Port, MA - 026752171 |
Business Phone Number: | 6178031228 |
Business Fax Number: | |
Mailing Address: | 319 Mayfair Rd, YARMOUTH PORT |
State: | MA |
Postal Code: | 026752229 |
Phone Number: | 7742894203 |
Fax Number: | |
NPI Enumeration Date: | 02/13/2007 |
NPI Last Update Date: | 03/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MALMHC1420 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |