Provider Demographics
NPI:1235561499
Name:OMOSOLA, KAREN DELCINA (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:DELCINA
Last Name:OMOSOLA
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 1:9145 ECHELON POINT DR UNIT 1017
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-3251
Mailing Address - Country:US
Mailing Address - Phone:702-466-4360
Mailing Address - Fax:
Practice Address - Street 1:8215 S EASTERN AVE STE 109
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2515
Practice Address - Country:US
Practice Address - Phone:702-466-4360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NVNV20243225195101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor