Provider Demographics
NPI:1093078008
Name:FAHSHOLTZ HOWELL, KYLE LYNN
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:LYNN
Last Name:FAHSHOLTZ HOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 OXFORD DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1827
Mailing Address - Country:US
Mailing Address - Phone:412-831-7570
Mailing Address - Fax:412-831-7073
Practice Address - Street 1:2000 OXFORD DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1827
Practice Address - Country:US
Practice Address - Phone:412-831-7570
Practice Address - Fax:412-831-7073
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT06259231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist