Provider Demographics
NPI:1700925104
Name:KINDLER, JEFFREY DARYL (PHD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DARYL
Last Name:KINDLER
Suffix:
Gender:M
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:PO BOX 83
Mailing Address - Street 2:
Mailing Address - City:NEFFS
Mailing Address - State:PA
Mailing Address - Zip Code:18065
Mailing Address - Country:US
Mailing Address - Phone:610-760-0426
Mailing Address - Fax:
Practice Address - Street 1:801 E GREEN ST
Practice Address - Street 2:KIDS PEACE BHRS
Practice Address - City:ALLANTOWN
Practice Address - State:PA
Practice Address - Zip Code:18109
Practice Address - Country:US
Practice Address - Phone:610-435-2608
Practice Address - Fax:610-799-8784
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005149L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist