Provider Demographics
NPI:1700834009
Name:DIES, KATHRYN GEARHART (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:GEARHART
Last Name:DIES
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 1:1445 MORNING ROSE PL
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-7035
Mailing Address - Country:US
Mailing Address - Phone:727-841-0044
Mailing Address - Fax:727-841-0043
Practice Address - Street 1:6322 ROWAN RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-3400
Practice Address - Country:US
Practice Address - Phone:727-841-0044
Practice Address - Fax:727-841-0043
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5421103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical