Doctor Name: | DR. KAY L BIENEMANN |
NPI Number: | 1013973122 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D |
License Number: | 071003241 |
Business Practice Address: | 17900 Dixie Hwy Suite 5 Homewood, IL - 604301754 |
Business Phone Number: | 7087989313 |
Business Fax Number: | |
Mailing Address: | 18001 Baker Ave, COUNTRY CLUB HILLS |
State: | IL |
Postal Code: | 604785046 |
Phone Number: | 7087989313 |
Fax Number: | |
NPI Enumeration Date: | 04/26/2006 |
NPI Last Update Date: | 01/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TA0700X |
License Number: | 071003241 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Adult Development & Aging |
Taxonomy Definition: |