Provider Demographics
NPI:1437256856
Name:TATROW, KRISTIN J (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:J
Last Name:TATROW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 226
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:PA
Mailing Address - Zip Code:18917-0226
Mailing Address - Country:US
Mailing Address - Phone:215-257-1633
Mailing Address - Fax:215-257-1633
Practice Address - Street 1:149 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:PA
Practice Address - Zip Code:18917-2107
Practice Address - Country:US
Practice Address - Phone:215-257-1633
Practice Address - Fax:215-257-1633
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015768103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAQ58431Medicare UPIN
PA096557NB0Medicare PIN