Doctor Name: | KENDRA NIEKAMP |
NPI Number: | 1356733448 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | OH3086510 |
Business Practice Address: | 1045 Dearbaugh Ave Wapakoneta, OH - 458959245 |
Business Phone Number: | 4197381267 |
Business Fax Number: | |
Mailing Address: | 1045 Dearbaugh Ave, WAPAKONETA |
State: | OH |
Postal Code: | 458959245 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/26/2015 |
NPI Last Update Date: | 02/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | OH3086510 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |