MEDICARE: KYMBERLE J ROBERTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist	1423541	IN

General Provider Information

NPI Number	:	1124851225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYMBERLE J ROBERTS

Provider Business Mailing Address
First Line	:	5201 E MAIN ST
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46033-9822
Country	:	US
Telephone Number	:	317-844-9961
Fax Number	:	317-844-9965

Provider Business Practice Location Address
First Line	:	5150 E 126TH ST
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46033-9746
Country	:	US
Telephone Number	:	317-844-7251
Fax Number	:	317-571-4020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2024
Last Update Date	:	08/23/2024

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Directions to “ KYMBERLE J ROBERTS ” Practice Location

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