Kenneth R. Pride is a Clinical in Ashwaubenon, Wisconsin. Kenneth R. Pride practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kenneth R. Pride is 1336221373. The last update date is 2007-07-09.
Kenneth R. Pride's current location address is 2129 So. Oneida, Ashwaubenon, Wisconsin. You can contact this provider via phone number 9204290159 and fax number 9204290161. The mailing address for Kenneth R. Pride is 2129 So. Oneida, Ashwaubenon, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth R. Pride |
|---|---|
| Address | 2129 So. Oneida, Ashwaubenon, Wisconsin |
| Phone Number | 9204290159 |
| Fax Number | 9204290161 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1336221373 |
|---|---|
| Provider Enumeration Date | 2006-10-19 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 2129 So. Oneida |
|---|---|
| City | Ashwaubenon |
| State | Wisconsin (WI) |
| Post Code | 54304 |
| Phone Number | 9204290159 |
| Fax Number | 9204290161 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 1583-057 |
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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 10-digit identification code issued to Kenneth R. Pride by the Centers for Medicare & Medicaid Services?
The Kenneth R. Pride has been assigned the NPI (National Provider Identifier) 1336221373 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Kenneth R. Pride is located?
The Kenneth R. Pride is situated at the following address: 2129 So. Oneida, Ashwaubenon, WI, 54304.
What is Kenneth R. Pride's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kenneth R. Pride'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 1336221373 to Kenneth R. Pride?
The Centers for Medicare & Medicaid Services assigned the 1336221373 to Kenneth R. Pride on 2006-10-19.
When was the Kenneth R. Pride's information last updated?
The Kenneth R. Pride's information was last updated on 2007-07-09.