Provider Demographics
NPI:1508900960
Name:KINARD, JACQUELINE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:ANN
Last Name:KINARD
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 1:3814 WEST ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-3752
Mailing Address - Country:US
Mailing Address - Phone:513-272-0329
Mailing Address - Fax:513-272-0330
Practice Address - Street 1:3814 WEST ST
Practice Address - Street 2:SUITE 305
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-3752
Practice Address - Country:US
Practice Address - Phone:513-272-0329
Practice Address - Fax:513-272-0330
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2999103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical