Provider Demographics
NPI:1669429627
Name:KINDERMAN, MICHELE BETH (PHD)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:BETH
Last Name:KINDERMAN
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 1:106 HAGERMAN CT
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-1674
Mailing Address - Country:US
Mailing Address - Phone:908-507-6363
Mailing Address - Fax:951-344-2284
Practice Address - Street 1:106 HAGERMAN CT
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-1674
Practice Address - Country:US
Practice Address - Phone:908-507-6363
Practice Address - Fax:951-344-2284
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100411600103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ083168TZZMedicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST