Provider Demographics
NPI:1053460154
Name:FREEZE, KAREN LORRAINE (NM D)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LORRAINE
Last Name:FREEZE
Suffix:
Gender:F
Credentials:NM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9221 S SAN PABLO DR
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-9320
Mailing Address - Country:US
Mailing Address - Phone:623-824-9600
Mailing Address - Fax:623-399-6919
Practice Address - Street 1:9221 S SAN PABLO DR
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-9320
Practice Address - Country:US
Practice Address - Phone:623-824-9600
Practice Address - Fax:623-399-6919
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
AZ03--778175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath