Doctor Name: | MS. KAREN LYNN WAKELEY |
NPI Number: | 1942657317 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MPS, LPC, ATR-BC |
License Number: | 002629 |
Business Practice Address: | 1445 E Putnam Ave Old Greenwich, CT - 068701379 |
Business Phone Number: | 2038345020 |
Business Fax Number: | 2035639936 |
Mailing Address: | 1445 E Putnam Ave, OLD GREENWICH |
State: | CT |
Postal Code: | 068701379 |
Phone Number: | 2038345020 |
Fax Number: | 2035639936 |
NPI Enumeration Date: | 05/16/2016 |
NPI Last Update Date: | 05/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 002629 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |