Doctor Name: | KIMBERLY HENDERSON-KJELLEN |
NPI Number: | 1417044165 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | 002808 |
Business Practice Address: | 33 Highland Street New Britain General Hospital Substance Abuse Services New Britain, CT - 06052 |
Business Phone Number: | 8602249985 |
Business Fax Number: | 8608264995 |
Mailing Address: | 33 Highland Street, New Britain General Hospital Substance Abuse Services NEW BRITAIN |
State: | CT |
Postal Code: | 06052 |
Phone Number: | 8602249985 |
Fax Number: | 8608264995 |
NPI Enumeration Date: | 10/06/2006 |
NPI Last Update Date: | 12/31/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 002808 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |