Provider Demographics
NPI:1336351667
Name:RABINEAU, KRISTEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:RABINEAU
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 1:4024 SAINT GERMAINE CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3810
Mailing Address - Country:US
Mailing Address - Phone:502-749-9161
Mailing Address - Fax:502-584-2449
Practice Address - Street 1:1238 E BROADWAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1714
Practice Address - Country:US
Practice Address - Phone:502-587-7981
Practice Address - Fax:502-584-2449
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1434103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent