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NPI Code Detail

MEDICARE: MRS. KAREN YVONNE WALDRON BA

MEDICARE:  MRS. KAREN YVONNE WALDRON  BA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorVA

General Provider Information

NPI Number : 1053533125
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAREN YVONNE WALDRON BA
Provider Business Mailing Address
First Line : PO BOX 552
Second Line :
City : POUNDING MILL
State : VA
Zip : 24637-0552
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 111 TOWN HOLLOW RD
Second Line :
City : CEDAR BLUFF
State : VA
Zip : 24609-9622
Country : US
Telephone Number : 276-963-3554
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. KAREN YVONNE WALDRON BA” Practice Location

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