Healthcare Provider Details

I. General information

NPI: 1245006618
Provider Name (Legal Business Name): KALILA JOHANNA BEEHLER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 11/28/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THE KEYSTONE BUILDING 3567 RESERVE COMMON DR
MEDINA OH
44256
US

IV. Provider business mailing address

2471 PITTVIEW AVE
PITTSBURGH PA
15209-2834
US

V. Phone/Fax

Practice location:
  • Phone: 330-536-3746
  • Fax: 330-267-4250
Mailing address:
  • Phone: 330-536-3746
  • Fax: 330-267-4250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS019990
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: