Provider Demographics
NPI:1811023609
Name:KATHRYN H BOBBITT, LLC
Entity Type:Organization
Organization Name:KATHRYN H BOBBITT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:H
Authorized Official - Last Name:BOBBITT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:740-373-3001
Mailing Address - Street 1:PO BOX 643
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0643
Mailing Address - Country:US
Mailing Address - Phone:740-374-4500
Mailing Address - Fax:740-374-5887
Practice Address - Street 1:200 UNION SQ
Practice Address - Street 2:SUITE 1
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3033
Practice Address - Country:US
Practice Address - Phone:740-373-3001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5239103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9337791Medicare PIN