Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist | ||
N | 102L00000X | Psychologist | 5725 | OH |
N | 103T00000X | Psychologist | 5725 | OH |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 5725 | OH |
N | 103TA0700X | Adult Development & Aging Psychologist | 5725 | OH |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 5725 | OH |
N | 103TC1900X | Counseling Psychologist | 5725 | OH |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 5725 | OH |
N | 103TP2701X | Group Psychotherapist | 5725 | OH |
NPI | 1245298819 |
---|---|
Provider Name | Dr. Karen M Desmarais |
First Address | Cleveland, OH 44106 |
Second Address | Cleveland, OH 44106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 31/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P22340 | (02) |