Healthcare Provider Details

I. General information

NPI: 1538825476
Provider Name (Legal Business Name): KAREN ELIZABETH ALLEN CMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAREN ELIZABETH THOMPSON CMA

II. Dates (important events)

Enumeration Date: 11/15/2021
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 CLIME RD
COLUMBUS OH
43228-6491
US

IV. Provider business mailing address

917 WOODLAND AVE
LANCASTER OH
43130-4875
US

V. Phone/Fax

Practice location:
  • Phone: 614-363-4489
  • Fax:
Mailing address:
  • Phone: 740-777-0074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number000000000
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: