Provider Demographics
NPI:1558327759
Name:DOBEK, KATHLEEN ANN (PSYD)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:DOBEK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500B SHALLCROSS AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-3027
Mailing Address - Country:US
Mailing Address - Phone:484-354-1232
Mailing Address - Fax:
Practice Address - Street 1:1500B SHALLCROSS AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-3027
Practice Address - Country:US
Practice Address - Phone:484-354-1232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000685103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical