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General NPI Number Information
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NPI Number | 1437336963
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Entity Type | Individual
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Provider Name | KELLY RENEE KINDER M.A.,ED.S.
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Gender | Female
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 10 MARLAND AVENUE
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City | HAMLIN
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State | WV
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Zip | 25523
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Country | US
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Telephone | 304-824-3033
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Fax |
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Provider Business Mailing Address
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Address Line | 102 ELIZABETH HTS
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City | HURRICANE
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State | WV
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Zip | 25526-9477
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Country | US
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Telephone | 304-542-1309
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3635
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License Number State | WV
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