Healthcare Provider Details
I. General information
NPI: 1912096488
Provider Name (Legal Business Name): NORMAN KINSLER PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/12/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8 CENTRE ST STE 2
CONCORD NH
03301-6302
US
IV. Provider business mailing address
8 CENTRE ST SUITE 2
CONCORD NH
03301-6302
US
V. Phone/Fax
- Phone: 603-228-7300
- Fax: 603-228-7301
- Phone: 603-228-7300
- Fax: 603-228-7301
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 540 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: