Provider Demographics
NPI:1154865517
Name:KOKORELIS, KARYN
Entity type:Individual
Prefix:
First Name:KARYN
Middle Name:
Last Name:KOKORELIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8948 SW 226TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1326
Mailing Address - Country:US
Mailing Address - Phone:305-479-7396
Mailing Address - Fax:
Practice Address - Street 1:8948 SW 226TH TER
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1326
Practice Address - Country:US
Practice Address - Phone:305-479-7396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician