Mary Alston Kerllenevich in St Augustine - Clinical
Mary Alston Kerllenevich - NPI 1386713048
Mary Alston Kerllenevich is a Clinical in St Augustine, Florida. Mary Alston Kerllenevich practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary Alston Kerllenevich is 1386713048. The last update date is 2008-08-12.
Mary Alston Kerllenevich's current location address is 1100 S Ponce De Leon Blvd Ste 1, St Augustine, Florida. You can contact this provider via phone number 9048247733 and fax number 9048299768. The mailing address for Mary Alston Kerllenevich is 1100 S Ponce De Leon Blvd Ste 1, St Augustine, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Alston Kerllenevich |
|---|---|
| Address | 1100 S Ponce De Leon Blvd Ste 1, St Augustine, Florida |
| Phone Number | 9048247733 |
| Fax Number | 9048299768 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1386713048 |
|---|---|
| Provider Enumeration Date | 2006-11-07 |
| Last Updated Date | 2008-08-12 |
Provider Mailing Address Detail
| Address | 1100 S Ponce De Leon Blvd Ste 1 |
|---|---|
| City | St Augustine |
| State | Florida (FL) |
| Post Code | 320846013 |
| Phone Number | 9048247733 |
| Fax Number | 9048299768 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PY7744 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique identifier code issued to Mary Alston Kerllenevich by the Centers for Medicare & Medicaid Services?
The Mary Alston Kerllenevich has been assigned the NPI (National Provider Identifier) 1386713048. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Mary Alston Kerllenevich's physical address?
The Mary Alston Kerllenevich is physically located at 1100 S Ponce De Leon Blvd Ste 1, in the city of St Augustine, FL, with the postal code 320846013.
What is Mary Alston Kerllenevich's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mary Alston Kerllenevich's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1386713048 to Mary Alston Kerllenevich?
The Centers for Medicare & Medicaid Services assigned the 1386713048 to Mary Alston Kerllenevich on 2006-11-07.
As of what date was the information regarding Mary Alston Kerllenevich, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Mary Alston Kerllenevich, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2008-08-12.