Provider Demographics
NPI:1760234306
Name:KENIN KRIEGER
Entity Type:Organization
Organization Name:KENIN KRIEGER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KENIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-330-6229
Mailing Address - Street 1:533 E CHAMBERS PIKE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-8005
Mailing Address - Country:US
Mailing Address - Phone:812-947-3316
Mailing Address - Fax:
Practice Address - Street 1:533 E CHAMBERS PIKE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-8005
Practice Address - Country:US
Practice Address - Phone:812-947-3316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)