Provider Demographics
NPI:1841494598
Name:KAHLE, ALICE (PHD)
Entity type:Individual
Prefix:DR
First Name:ALICE
Middle Name:
Last Name:KAHLE
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 1:811 SAINT MICHAELS DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7641
Mailing Address - Country:US
Mailing Address - Phone:505-992-2878
Mailing Address - Fax:
Practice Address - Street 1:811 SAINT MICHAELS DR
Practice Address - Street 2:SUITE 105
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7641
Practice Address - Country:US
Practice Address - Phone:505-992-2878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0863103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical