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General NPI Number Information
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NPI Number | 1992164693
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Entity Type | Individual
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Provider Name | KAREN MCAVOY
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Gender | Female
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Dates
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Enumeration Date | 02/23/2016
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Last Update Date | 03/13/2019
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Provider Practice Location Address
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Address Line | 2021 BATTLECREEK DR UNIT A
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City | FORT COLLINS
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State | CO
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Zip | 80528-5120
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Country | US
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Telephone | 970-984-8765
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Fax |
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Provider Business Mailing Address
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Address Line | 631 PETERSON ST
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City | FORT COLLINS
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State | CO
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Zip | 80524-3135
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Country | US
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Telephone | 303-818-8765
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY.0001472
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License Number State | CO
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