Healthcare Provider Details

I. General information

NPI: 1902382435
Provider Name (Legal Business Name): KAREN DOLORES HUTTEMANN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2018
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 BEY LEA RD BLDG 9
TOMS RIVER NJ
08753-2989
US

IV. Provider business mailing address

40 BEY LEA RD BLDG A
TOMS RIVER NJ
08753-2989
US

V. Phone/Fax

Practice location:
  • Phone: 732-349-5550
  • Fax:
Mailing address:
  • Phone: 732-349-5550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number5959
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: