Provider Demographics
NPI:1356433577
Name:KERN, KATHLEEN M
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:M
Last Name:KERN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 LOOMIS ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4134
Mailing Address - Country:US
Mailing Address - Phone:203-878-1056
Mailing Address - Fax:
Practice Address - Street 1:114 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-2043
Practice Address - Country:US
Practice Address - Phone:203-931-4058
Practice Address - Fax:203-931-4068
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor