Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 502 | SD |
N | 103TC0700X | Clinical Psychologist | 502 | SD |
N | 103G00000X | Clinical Psychologist | 6301009161 | MI |
N | 103TC0700X | Clinical Psychologist | 6301009161 | MI |
Y | 103G00000X | Clinical Psychologist | P.07601 | OH |
Y | 103TC0700X | Clinical Psychologist | P.07601 | OH |
N | 103G00000X | Clinical Psychologist | PS016529 | PA |
N | 103TC0700X | Clinical Psychologist | PS016529 | PA |
N | 103TR0400X | Rehabilitation Psychologist | 502 | SD |
N | 103TR0400X | Rehabilitation Psychologist | 6301009161 | MI |
N | 103TR0400X | Rehabilitation Psychologist | P.07601 | OH |
N | 103TR0400X | Rehabilitation Psychologist | PS016529 | PA |
NPI | 1427125400 |
---|---|
Provider Name | Dr. Kenneth Dale Hasseler |
First Address | Zanesville, OH 43701-3771 |
Second Address | Zanesville, OH 43701-3771 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 30/10/2018 |