Provider Demographics
NPI:1407025828
Name:HAENLE, KIMBERLY B (MS, CAC DIPLOMATE)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:B
Last Name:HAENLE
Suffix:
Gender:F
Credentials:MS, CAC DIPLOMATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 FLORAL VALE BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5524
Mailing Address - Country:US
Mailing Address - Phone:215-968-7600
Mailing Address - Fax:215-968-7609
Practice Address - Street 1:203 FLORAL VALE BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5524
Practice Address - Country:US
Practice Address - Phone:215-968-7600
Practice Address - Fax:215-968-7609
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor