Provider Demographics
NPI:1962692947
Name:DOOLITTLE, KAREN IRENE (MS)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:IRENE
Last Name:DOOLITTLE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:KINNEAR
Mailing Address - State:WY
Mailing Address - Zip Code:82516-0085
Mailing Address - Country:US
Mailing Address - Phone:307-856-3351
Mailing Address - Fax:
Practice Address - Street 1:15 GABES ROAD
Practice Address - Street 2:
Practice Address - City:KINNEAR
Practice Address - State:WY
Practice Address - Zip Code:82516-0085
Practice Address - Country:US
Practice Address - Phone:307-856-3351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-266101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor