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General NPI Number Information
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NPI Number | 1598750804
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Entity Type | Individual
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Provider Name | STEPHEN KAHN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 33 WHITE OAK RIDGE RD
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City | DAMARISCOTTA
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State | ME
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Zip | 04543-4257
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Country | US
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Telephone | 773-793-3322
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Fax |
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Provider Business Mailing Address
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Address Line | 33 WHITE OAK RIDGE RD
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City | DAMARISCOTTA
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State | ME
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Zip | 04543-4257
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Country | US
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Telephone | 773-793-3322
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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 | 071-003404
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License Number State | IL
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