Provider Demographics
NPI:1558998724
Name:KENT, ALINE TILITHIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALINE
Middle Name:TILITHIA
Last Name:KENT
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 1:2347 CHANDLER MILL RD
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27311-8778
Mailing Address - Country:US
Mailing Address - Phone:336-939-7950
Mailing Address - Fax:
Practice Address - Street 1:2347 CHANDLER MILL RD
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NC
Practice Address - Zip Code:27311-8778
Practice Address - Country:US
Practice Address - Phone:336-939-7950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VABCPC0798101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral