Provider Demographics
NPI:1699909697
Name:PAQUIN, KARLA M (MHP)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:M
Last Name:PAQUIN
Suffix:
Gender:F
Credentials:MHP
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:M
Other - Last Name:MENJIVAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHP
Mailing Address - Street 1:1509 OGELTHORPE AVE
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61802-4735
Mailing Address - Country:US
Mailing Address - Phone:217-384-0158
Mailing Address - Fax:
Practice Address - Street 1:1801 FOX DR
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-7236
Practice Address - Country:US
Practice Address - Phone:217-398-8080
Practice Address - Fax:217-398-0172
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker