Provider Demographics
NPI:1124147350
Name:HUBBARD, KAREN GARISON (MED, LMFT)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:GARISON
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:MED, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2362
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77516-2362
Mailing Address - Country:US
Mailing Address - Phone:979-799-5524
Mailing Address - Fax:888-848-2411
Practice Address - Street 1:201 E MYRTLE ST # 236
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-4763
Practice Address - Country:US
Practice Address - Phone:979-799-5524
Practice Address - Fax:888-848-2411
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3455106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1484768-01Medicaid