Provider Demographics
NPI:1326151390
Name:SPRINGER, KATHRYN A (PSYD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:SPRINGER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 S COUNTY ROAD 400 W
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:IN
Mailing Address - Zip Code:47882-7238
Mailing Address - Country:US
Mailing Address - Phone:812-382-4163
Mailing Address - Fax:
Practice Address - Street 1:2740 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-3559
Practice Address - Country:US
Practice Address - Phone:812-235-6121
Practice Address - Fax:812-235-4565
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042042A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical