Healthcare Provider Details

I. General information

NPI: 1265086227
Provider Name (Legal Business Name): KIMBERLY DYANNE AKER PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2019
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 FERNBROOK AVE
WYNCOTE PA
19095-1532
US

IV. Provider business mailing address

9300 LOTTSFORD RD APT 1405
UPPER MARLBORO MD
20774-4892
US

V. Phone/Fax

Practice location:
  • Phone: 347-860-0149
  • Fax:
Mailing address:
  • Phone: 267-463-0523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS018166
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPS018166
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS018166
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: