Basic Information
| Provider Information | |||||||||
| NPI: | 1730300203 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KARN | ||||||||
| FirstName: | ELISSA | ||||||||
| MiddleName: | RICHARDS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | ED.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11766 E MARIPOSA GRANDE DR | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852555662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804733780 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 20402 N 15TH AVE | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850273636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6234454952 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 07/25/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TS0200X | AZ | Y | Behavioral Health & Social Service Providers | Psychologist | School |
No ID Information.