Provider Demographics
NPI:1407212764
Name:KURIVIAL, KATHRYN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:KURIVIAL
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 1:41 LEOPARD RD
Mailing Address - Street 2:EXECUTIVE GREEN BUILDING 1, SUITE 304
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1549
Mailing Address - Country:US
Mailing Address - Phone:610-647-6406
Mailing Address - Fax:610-407-0302
Practice Address - Street 1:41 LEOPARD RD
Practice Address - Street 2:EXECUTIVE GREEN BUILDING 1, SUITE 304
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1549
Practice Address - Country:US
Practice Address - Phone:610-647-6406
Practice Address - Fax:610-407-0302
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-01
Last Update Date:2016-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-017900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical