MEDICARE: DOROTHY S KAHLER PSYD

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	103G00000X	Clinical Neuropsychologist	6301007970	MI
2	103T00000X	Psychologist	6301007970	MI

General Provider Information

NPI Number	:	1871576421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY S KAHLER PSYD

Provider Business Mailing Address
First Line	:	290 RUBLEIN
Second Line	:	SUITE D
City	:	MARQUETTE
State	:	MI
Zip	:	49855
Country	:	US
Telephone Number	:	906-226-9100
Fax Number	:

Provider Business Practice Location Address
First Line	:	290 RUBLEIN ST
Second Line	:	SUITE D
City	:	MARQUETTE
State	:	MI
Zip	:	49855-4067
Country	:	US
Telephone Number	:	906-226-9100
Fax Number	:

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

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	07/16/2007

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