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NPI Code Detail

MEDICARE: MR. ROBERT NEIL KITTLE SR. M.A.,M.DIV.,L.C.P.C.

MEDICARE: MR. ROBERT NEIL KITTLE SR. M.A.,M.DIV.,L.C.P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor0534MD

General Provider Information

NPI Number : 1407068257
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT NEIL KITTLE SR. M.A.,M.DIV.,L.C.P.C.
Provider Business Mailing Address
First Line : 3919 KLAUSMIER RD
Second Line :
City : NOTTINGHAM
State : MD
Zip : 21236-1418
Country : US
Telephone Number : 410-529-9335
Fax Number :
Provider Business Practice Location Address
First Line : 16 GREENMEADOW DR
Second Line : SUITE 106
City : TIMONIUM
State : MD
Zip : 21093-3200
Country : US
Telephone Number : 410-561-9584
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2007
Last Update Date : 07/08/2007

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