Provider Demographics
NPI:1558635722
Name:DR. DONALD KINSLEY & ASSOCIATE
Entity Type:Organization
Organization Name:DR. DONALD KINSLEY & ASSOCIATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:KINSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:330-493-0076
Mailing Address - Street 1:1740 WINONA ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4570
Mailing Address - Country:US
Mailing Address - Phone:330-606-6119
Mailing Address - Fax:
Practice Address - Street 1:4450 BELDEN VILLAGE ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2552
Practice Address - Country:US
Practice Address - Phone:330-493-0076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1045103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty