Healthcare Provider Details

I. General information

NPI: 1821246497
Provider Name (Legal Business Name): KAREN L WEIGLE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 BURLEYSON RD
DALTON GA
30720-3019
US

IV. Provider business mailing address

1201 BURLEYSON RD
DALTON GA
30720-3019
US

V. Phone/Fax

Practice location:
  • Phone: 706-226-8900
  • Fax: 706-226-8905
Mailing address:
  • Phone: 706-226-8900
  • Fax: 706-226-8905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY900296
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: