Healthcare Provider Details

I. General information

NPI: 1831424530
Provider Name (Legal Business Name): KELLY GENE ARNEMANN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 10/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 MERTON MINTER BLVD PSYCHOLOGY SERVICE (116B)
SAN ANTONIO TX
78229
US

IV. Provider business mailing address

7400 MERTON MINTER BLVD PSYCHOLOGY SERVICE (116B)
SAN ANTONIO TX
78229
US

V. Phone/Fax

Practice location:
  • Phone: 210-617-5300
  • Fax: 210-617-5178
Mailing address:
  • Phone: 210-617-5300
  • Fax: 210-617-5178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: