Healthcare Provider Details

I. General information

NPI: 1063645521
Provider Name (Legal Business Name): KAREN ARNOLD ED.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 NE 202ND TER
WILLISTON FL
32696-2875
US

IV. Provider business mailing address

2351 NE 202ND TER
WILLISTON FL
32696-2875
US

V. Phone/Fax

Practice location:
  • Phone: 352-214-0201
  • Fax: 866-626-9631
Mailing address:
  • Phone: 352-214-0201
  • Fax: 866-626-9631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License NumberSS 704
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: