Healthcare Provider Details

I. General information

NPI: 1184069908
Provider Name (Legal Business Name): KAREN ELIZABETH KOCHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6802 MCCLEAN BLVD
BALTIMORE MD
21234-7260
US

IV. Provider business mailing address

6802 MCCLEAN BLVD
BALTIMORE MD
21234-7260
US

V. Phone/Fax

Practice location:
  • Phone: 443-540-5246
  • Fax:
Mailing address:
  • Phone: 443-540-5246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15466
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: