Provider Demographics
NPI:1467423756
Name:CODDINGTON, KIMBERLEY S (PHD)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLEY
Middle Name:S
Last Name:CODDINGTON
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 1:310 CHESTNUT ST STE 230
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-3295
Mailing Address - Country:US
Mailing Address - Phone:814-763-4802
Mailing Address - Fax:
Practice Address - Street 1:310 CHESTNUT ST STE 230
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3295
Practice Address - Country:US
Practice Address - Phone:814-337-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016291103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist