| Susan K Kahle Phd Llc | |
|
2600 Far Hills Ave Suite 321 Dayton OH 45419-1687 | |
| (937) 901-3122 | |
| (937) 294-1470 |
| Full Name | Susan K Kahle Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2600 Far Hills Ave, Dayton, Ohio |
| Authorized Official Name and Position | Susan K Kahle (PROVIDER/ SOLE MEMBER) |
| Authorized Official Contact | 9379013122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan K Kahle Phd Llc 2600 Far Hills Ave Suite 321 Dayton OH 45419-1687 Ph: (937) 901-3122 | Susan K Kahle Phd Llc 2600 Far Hills Ave Suite 321 Dayton OH 45419-1687 Ph: (937) 901-3122 |
| NPI Number | 1689979353 |
|---|---|
| Provider Enumeration Date | 01/11/2011 |
| Last Update Date | 01/11/2011 |
| Medicare PECOS PAC ID | 3173703733 |
|---|---|
| Medicare Enrollment ID | O20110215000005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689979353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 5806 (Ohio) | Primary |
| Provider Name | Susan K Kahle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366558645 PECOS PAC ID: 5294782967 Enrollment ID: I20050405000541 |
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