Doctor Name: | KIMBERLY KOEBLER |
NPI Number: | 1194136531 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | |
Business Practice Address: | 552 Washington Ave Carnegie, PA - 151062848 |
Business Phone Number: | 4124291908 |
Business Fax Number: | 4124290800 |
Mailing Address: | 149 Demar Blvd, CANONSBURG |
State: | PA |
Postal Code: | 153172215 |
Phone Number: | 7244131204 |
Fax Number: | |
NPI Enumeration Date: | 05/19/2014 |
NPI Last Update Date: | 05/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |