Provider Demographics
NPI:1518082866
Name:KAHN, MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:KAHN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 JUMPERS HOLE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-1600
Mailing Address - Country:US
Mailing Address - Phone:410-647-8840
Mailing Address - Fax:410-647-1405
Practice Address - Street 1:479 JUMPERS HOLE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-1600
Practice Address - Country:US
Practice Address - Phone:410-647-8840
Practice Address - Fax:410-647-1405
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1630103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical