Provider Demographics
NPI:1154587392
Name:BROWNELL, KAREN MARY (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:MARY
Last Name:BROWNELL
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:MARY
Other - Last Name:BROWNELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MASSAGE THERAPIST
Mailing Address - Street 1:9 PARK AVE
Mailing Address - Street 2:PO BOX 235
Mailing Address - City:PIERCEFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:12973-0235
Mailing Address - Country:US
Mailing Address - Phone:518-359-3220
Mailing Address - Fax:
Practice Address - Street 1:9 PARK AVE
Practice Address - Street 2:
Practice Address - City:PIERCEFIELD
Practice Address - State:NY
Practice Address - Zip Code:12973-0235
Practice Address - Country:US
Practice Address - Phone:518-359-3220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020064225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist