Provider Demographics
NPI:1851357099
Name:HYNES, KATHRYN A (MS)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:A
Last Name:HYNES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:853 HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1130
Mailing Address - Country:US
Mailing Address - Phone:610-933-4583
Mailing Address - Fax:610-933-4583
Practice Address - Street 1:510 N PARK RD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2941
Practice Address - Country:US
Practice Address - Phone:610-375-4080
Practice Address - Fax:610-375-7363
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002843-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0236643000OtherINDEPENDENCE BLUE CROSS
PA236643OtherAMERIHEATH
PA50031703OtherCAPITOL BLUE CROSS
PA463513OtherHIGHMARK BLUE SHIELD