Provider Demographics
NPI:1063564920
Name:PAPE, KAREN DIANE (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:DIANE
Last Name:PAPE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:DIANE TAYLOR
Other - Last Name:PAPE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1070 CAMBRIDGE SQUARE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004
Mailing Address - Country:US
Mailing Address - Phone:770-569-2629
Mailing Address - Fax:770-569-2630
Practice Address - Street 1:1070 CAMBRIDGE SQUARE
Practice Address - Street 2:SUITE A
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004
Practice Address - Country:US
Practice Address - Phone:770-569-2629
Practice Address - Fax:770-569-2630
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY001927103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical