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General NPI Number Information
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NPI Number | 1073759809
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Entity Type | Organization
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Legal Business Name | KINDERBUCH US P C
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Dates
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Enumeration Date | 12/29/2008
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Last Update Date | 02/11/2014
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Provider Practice Location Address
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Address Line | 150 MONUMENT RD SUITE 107
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1702
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Country | US
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Telephone | 877-760-5437
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Fax | 877-760-5437
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Provider Business Mailing Address
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Address Line | PO BOX 5794
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City | KINGWOOD
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State | TX
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Zip | 77325-5794
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Country | US
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Telephone | 877-760-5437
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Fax | 877-760-5437
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Authorized Official
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Title or Position | MANAGER OF OPERATIONS
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Name | MS. BETINA L BURDEN
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Credential |
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Telephone | 281-657-6052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PS016206
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS016206
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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