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General NPI Number Information
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NPI Number | 1750687877
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Entity Type | Individual
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Provider Name | KATHLEEN R DINE PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 02/07/2011
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 330 TABERNACLE RD
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City | BLACK MOUNTAIN
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State | NC
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Zip | 28711-2536
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Country | US
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Telephone | 502-438-0506
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Fax | 888-972-1943
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Provider Business Mailing Address
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Address Line | 330 TABERNACLE RD
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City | BLACK MOUNTAIN
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State | NC
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Zip | 28711-2536
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Country | US
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Telephone | 502-438-0506
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Fax | 888-972-1943
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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 | 1125
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License Number State | KY
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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 | 20041479A
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License Number State | IN
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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 | 130426
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License Number State | KY
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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 | 6291
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License Number State | NC
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