Provider Demographics
NPI:1285451195
Name:MARION, KAREN L (BCABA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:MARION
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17641 HIGHWAY HH
Mailing Address - Street 2:
Mailing Address - City:NEOSHO
Mailing Address - State:MO
Mailing Address - Zip Code:64850-6450
Mailing Address - Country:US
Mailing Address - Phone:417-825-6529
Mailing Address - Fax:
Practice Address - Street 1:418 FAIRGROUND RD
Practice Address - Street 2:
Practice Address - City:NEOSHO
Practice Address - State:MO
Practice Address - Zip Code:64850-1626
Practice Address - Country:US
Practice Address - Phone:417-451-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023007258106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst