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General NPI Number Information
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NPI Number | 1730106790
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Entity Type | Individual
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Provider Name | LORENA L KVALHEIM PSY.D
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Gender | Female
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 1020 WOODMAN STREET SUITE 300
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City | DAYTON
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State | OH
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Zip | 45432
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Country | US
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Telephone | 937-254-9210
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Fax | 937-254-9267
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Provider Business Mailing Address
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Address Line | P.O. BOX 341648
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City | DAYTON
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State | OH
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Zip | 45434
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Country | US
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Telephone | 937-254-9210
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Fax | 937-254-9267
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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 | 6215
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License Number State | OH
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