Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 4362 | NJ |
N | 103TC0700X | Clinical Psychologist | 4362 | NJ |
N | 102L00000X | Psychologist | 0132182 | NY |
N | 103T00000X | Psychologist | 0132182 | NY |
Y | 103G00000X | Clinical Psychologist | 0131282 | NY |
Y | 103TC0700X | Clinical Psychologist | 0131282 | NY |
N | 103TH0100X | Health Service | 4362 | NJ |
N | 103TR0400X | Rehabilitation Psychologist | 4362 | NJ |
NPI | 1477616670 |
---|---|
Provider Name | Dr. Karen Michelle Faherty |
First Address | Red Bank, NJ 07701-1734 |
Second Address | Red Bank, NJ 07701-1734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 17/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0132182 | (02) | NJ |