Provider Demographics
NPI:1609255504
Name:HIMELREICH, KATHRYN (MSED, LBS)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:
Last Name:HIMELREICH
Suffix:
Gender:F
Credentials:MSED, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 895
Mailing Address - Street 2:
Mailing Address - City:SKIPPACK
Mailing Address - State:PA
Mailing Address - Zip Code:19474-0895
Mailing Address - Country:US
Mailing Address - Phone:302-377-8945
Mailing Address - Fax:
Practice Address - Street 1:3839 SKIPPACK PIKE
Practice Address - Street 2:2ND FLOOR WEST
Practice Address - City:SKIPPACK
Practice Address - State:PA
Practice Address - Zip Code:19474
Practice Address - Country:US
Practice Address - Phone:302-377-8945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001467103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst