Provider Demographics
NPI:1750480497
Name:AYERS, KATHRYN (PSYD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:AYERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 WASHINGTON PL
Mailing Address - Street 2:CHESTERBROOK
Mailing Address - City:CHESTERBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19087-5868
Mailing Address - Country:US
Mailing Address - Phone:610-993-3112
Mailing Address - Fax:
Practice Address - Street 1:521 WASHINGTON PL
Practice Address - Street 2:CHESTERBROOK
Practice Address - City:CHESTERBROOK
Practice Address - State:PA
Practice Address - Zip Code:19087-5868
Practice Address - Country:US
Practice Address - Phone:610-993-3112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006199-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2318724000OtherPERSONAL CHOICE
PA467089OtherBCBS