Provider Demographics
NPI:1346406261
Name:SCHLEGEL, KARA MICHELLE (PSYD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:MICHELLE
Last Name:SCHLEGEL
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 1:1130 VESTER AVE
Mailing Address - Street 2:STE. C
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-7302
Mailing Address - Country:US
Mailing Address - Phone:937-390-3800
Mailing Address - Fax:
Practice Address - Street 1:1130 VESTER AVE
Practice Address - Street 2:STE. C
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-7302
Practice Address - Country:US
Practice Address - Phone:937-390-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6346103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical