Healthcare Provider Details

I. General information

NPI: 1417997594
Provider Name (Legal Business Name): JOSEPH KEITH KAHLER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7916 WRENWOOD BLVD SUITE C
BATON ROUGE LA
70809-1782
US

IV. Provider business mailing address

7916 WRENWOOD BLVD SUITE C
BATON ROUGE LA
70809-1782
US

V. Phone/Fax

Practice location:
  • Phone: 225-892-4352
  • Fax:
Mailing address:
  • Phone: 225-892-4352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number678
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: