Provider Demographics
NPI:1609860428
Name:KEHR, JAMES JACK (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JACK
Last Name:KEHR
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:PSC 2
Mailing Address - Street 2:BOX 12287
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09012-0031
Mailing Address - Country:US
Mailing Address - Phone:49637-147-7318
Mailing Address - Fax:49637-147-9882
Practice Address - Street 1:HQ USAFE/SG
Practice Address - Street 2:UNIT 3050 BOX 130
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09094-0130
Practice Address - Country:US
Practice Address - Phone:49637-147-7318
Practice Address - Fax:49637-147-9882
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 13710103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical