Provider Demographics
NPI:1699427930
Name:VANNATTER, KAREN MICHELLE (MA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MICHELLE
Last Name:VANNATTER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 MORRISON DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2322
Mailing Address - Country:US
Mailing Address - Phone:681-282-5678
Mailing Address - Fax:304-362-8244
Practice Address - Street 1:108 MORRISON DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2322
Practice Address - Country:US
Practice Address - Phone:681-282-5678
Practice Address - Fax:304-362-8244
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2697101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor