Doctor Name: | MICHELE JOY KERN |
NPI Number: | 1154344331 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 003051-1 |
Business Practice Address: | 138 North Court St. Wampsville, NY - 13163 |
Business Phone Number: | 3153662327 |
Business Fax Number: | 3153662599 |
Mailing Address: | 5222 S Main St, MUNNSVILLE |
State: | NY |
Postal Code: | 134094059 |
Phone Number: | 3154955732 |
Fax Number: | |
NPI Enumeration Date: | 07/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 003051-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |