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General NPI Number Information
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NPI Number | 1972991214
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Entity Type | Organization
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Legal Business Name | KAFFER PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 01/08/2015
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Last Update Date | 01/08/2015
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Provider Practice Location Address
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Address Line | 10451 W PALMERAS DR STE 105W
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City | SUN CITY
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State | AZ
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Zip | 85373-2602
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Country | US
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Telephone | 309-252-2410
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Fax |
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Provider Business Mailing Address
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Address Line | 10451 W PALMERAS DR STE 105W
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City | SUN CITY
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State | AZ
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Zip | 85373-2602
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | JESSICA L KAFFER
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Credential | PSYD
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Telephone | 309-252-2410
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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 |
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License Number State |
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