Provider Demographics
NPI:1083105605
Name:KINSTLE, TERRI STEWART (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERRI
Middle Name:STEWART
Last Name:KINSTLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 KINGSBERRY WAY
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-2736
Mailing Address - Country:US
Mailing Address - Phone:413-695-2164
Mailing Address - Fax:
Practice Address - Street 1:28 KINGSBERRY WAY
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-2736
Practice Address - Country:US
Practice Address - Phone:413-695-2164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8982103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist