Healthcare Provider Details

I. General information

NPI: 1992135040
Provider Name (Legal Business Name): KARA WATERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2013
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 W MAIN ST
CARMEL IN
46032-1764
US

IV. Provider business mailing address

6258 SADDLETREE DR
ZIONSVILLE IN
46077-8256
US

V. Phone/Fax

Practice location:
  • Phone: 765-729-2567
  • Fax:
Mailing address:
  • Phone: 765-729-2567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-15-21018
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: