Provider Demographics
NPI:1366566382
Name:FRAGETTA, KAREN CAMPBELL (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:CAMPBELL
Last Name:FRAGETTA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2324 W JOPPA RD
Mailing Address - Street 2:SUITES 220 & 410
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4615
Mailing Address - Country:US
Mailing Address - Phone:410-583-2622
Mailing Address - Fax:410-583-2949
Practice Address - Street 1:2324 W JOPPA RD
Practice Address - Street 2:SUITES 220 & 410
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4615
Practice Address - Country:US
Practice Address - Phone:410-583-2622
Practice Address - Fax:410-583-2949
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02707103TC0700X, 103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist