Basic Information
| Provider Information | |||||||||
| NPI: | 1689028672 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KARR | ||||||||
| FirstName: | AUTUMN | ||||||||
| MiddleName: | ROSE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 FAIRWAY DR | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | DEERFIELD BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334411814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8888809720 | ||||||||
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| Practice Location | |||||||||
| Address1: | 421 FAYETTEVILLE ST | ||||||||
| Address2: | SUITE 1100 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276011792 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8888909270 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2016 | ||||||||
| LastUpdateDate: | 04/16/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 222Q00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist |
No ID Information.