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General NPI Number Information
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NPI Number | 1770791295
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Entity Type | Individual
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Provider Name | PETER JOSEPH KAHN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 10/27/2007
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Provider Practice Location Address
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Address Line | CARRUTH CENTER FOR COUNSELING, COLLEGE AVE. RM 303 STUDENT SERVICES CENTER BUILDING
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City | MORGANTOWN
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State | WV
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Zip | 26506-6422
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Country | US
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Telephone | 304-293-4431
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Fax | 304-293-3705
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Provider Business Mailing Address
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Address Line | CARRUTH CENTER FOR COUNSELING, COLLEGE AVE. RM 303 STUDENT SERVICES CENTER BUILDING
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City | MORGANTOWN
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State | WV
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Zip | 26506-6422
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Country | US
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Telephone | 304-293-4431
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Fax | 304-293-3705
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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 | 814
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License Number State | WV
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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 | 814
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License Number State | WV
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