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General NPI Number Information
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NPI Number | 1033496542
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Entity Type | Individual
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Provider Name | KATHLEEN ANN TOBIN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/11/2011
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Last Update Date | 11/11/2011
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Provider Practice Location Address
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Address Line | 17 SENIOR ST
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-8534
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Country | US
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Telephone | 732-932-7884
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Fax |
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Provider Business Mailing Address
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Address Line | 212 VILLAGE RD E
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City | WEST WINDSOR
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State | NJ
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Zip | 08550-2417
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Country | US
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Telephone | 631-896-7645
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 073-865
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 018845-1
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License Number State | NY
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