Provider Demographics
NPI:1053958868
Name:QUIGLEY, KAREN M (MA)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:M
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4749 GAYNOR RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-3020
Mailing Address - Country:US
Mailing Address - Phone:520-955-9503
Mailing Address - Fax:
Practice Address - Street 1:6000 FAIRVIEW RD FL 12
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-2224
Practice Address - Country:US
Practice Address - Phone:520-955-9503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-30
Last Update Date:2019-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2048106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist