Provider Demographics
NPI:1902382435
Name:HUTTEMANN, KAREN DOLORES (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:DOLORES
Last Name:HUTTEMANN
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 1:40 BEY LEA RD BLDG A
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2989
Mailing Address - Country:US
Mailing Address - Phone:732-349-5550
Mailing Address - Fax:
Practice Address - Street 1:40 BEY LEA RD BLDG 9
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2989
Practice Address - Country:US
Practice Address - Phone:732-349-5550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5959103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist