Healthcare Provider Details

I. General information

NPI: 1073593844
Provider Name (Legal Business Name): KAREN SUE GUEST PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 12/16/2023
Certification Date: 12/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 E CLEMMER AVE
CHAMBERLAIN SD
57325-1308
US

IV. Provider business mailing address

108 E CLEMMER AVE
CHAMBERLAIN SD
57325-1308
US

V. Phone/Fax

Practice location:
  • Phone: 605-734-6347
  • Fax: 605-734-0577
Mailing address:
  • Phone: 605-734-6347
  • Fax: 605-734-0577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number350
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT1161
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: