Doctor Name: | SUSAN KIMMEL |
NPI Number: | 1013382142 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSW |
License Number: | SW132982 |
Business Practice Address: | Georgian Place Suite 309 Somerset, PA - 15501 |
Business Phone Number: | 8144440620 |
Business Fax Number: | |
Mailing Address: | Georgian Place, Suite 309 SOMERSET |
State: | PA |
Postal Code: | 15501 |
Phone Number: | 8144440620 |
Fax Number: | |
NPI Enumeration Date: | 12/01/2015 |
NPI Last Update Date: | 12/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | SW132982 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |