Provider Demographics
NPI:1720329642
Name:THEURER-KAUFMAN, KARIN LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:KARIN
Middle Name:LEE
Last Name:THEURER-KAUFMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HUNT CLUB DR
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-9121
Mailing Address - Country:US
Mailing Address - Phone:585-734-3603
Mailing Address - Fax:
Practice Address - Street 1:11 HUNT CLUB DR
Practice Address - Street 2:
Practice Address - City:HONEOYE FALLS
Practice Address - State:NY
Practice Address - Zip Code:14472-9121
Practice Address - Country:US
Practice Address - Phone:585-734-4768
Practice Address - Fax:585-367-4734
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009460-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist