Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PS007878 L | PA |
N | 103T00000X | Psychologist | PS007878 L | PA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 1133 | PA |
N | 103TC1900X | Counseling Psychologist | PC000722 | PA |
NPI | 1124193156 |
---|---|
Provider Name | Mrs. Kay C Kintzel |
First Address | Emmaus, PA 18049 |
Second Address | Emmaus, PA 18049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 08/07/2007 |