Healthcare Provider Details

I. General information

NPI: 1255492799
Provider Name (Legal Business Name): KAREN L CORONA-LONDRE PSYD, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN L LONDRE PSYD, BCBA

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 08/05/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 RUDY STREET
ONALASKA WI
54650
US

IV. Provider business mailing address

W11191 HAGEN LANE
BLACK RIVER FALLS WI
54615-5994
US

V. Phone/Fax

Practice location:
  • Phone: 715-299-4668
  • Fax: 715-670-0775
Mailing address:
  • Phone: 715-299-4668
  • Fax: 715-670-0775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2328-057
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2328057
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLP5638
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2328-57
License Number StateWI
# 5
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number134-140
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: