| Doctor Name: | DR. JOEL MANDEL KESTENBAUM |
| NPI Number: | 1942208210 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | 2049 |
| Business Practice Address: | 922 Dixie Hwy Rossford, OH - 434601333 |
| Business Phone Number: | 4196612779 |
| Business Fax Number: | 4196610890 |
| Mailing Address: | Po Box 60347, ROSSFORD |
| State: | OH |
| Postal Code: | 434600347 |
| Phone Number: | 4196612779 |
| Fax Number: | 4196610890 |
| NPI Enumeration Date: | 07/12/2005 |
| NPI Last Update Date: | 12/12/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2049 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |