Healthcare Provider Details

I. General information

NPI: 1871576421
Provider Name (Legal Business Name): DOROTHY S KAHLER PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 RUBLEIN ST SUITE D
MARQUETTE MI
49855-4067
US

IV. Provider business mailing address

290 RUBLEIN SUITE D
MARQUETTE MI
49855
US

V. Phone/Fax

Practice location:
  • Phone: 906-226-9100
  • Fax:
Mailing address:
  • Phone: 906-226-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number6301007970
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301007970
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: