Kenneth Dittmar is a Clinical in Fayetteville, North Carolina. Kenneth Dittmar practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kenneth Dittmar is 1457447765. The last update date is 2010-03-29.
Kenneth Dittmar's current location address is 109 Bradford Ave, Fayetteville, North Carolina. You can contact this provider via phone number 9103232311. The mailing address for Kenneth Dittmar is 109 Bradford Ave, Fayetteville, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Dittmar |
|---|---|
| Address | 109 Bradford Ave, Fayetteville, North Carolina |
| Phone Number | 9103232311 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | M. S. |
NPI Number Detail
| NPI Number | 1457447765 |
|---|---|
| Provider Enumeration Date | 2006-10-05 |
| Last Updated Date | 2010-03-29 |
Provider Mailing Address Detail
| Address | 109 Bradford Ave |
|---|---|
| City | Fayetteville |
| State | North Carolina (NC) |
| Post Code | 283015401 |
| Phone Number | 9103232311 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 503 |
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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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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6107330 | NC | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Kenneth Dittmar?
The Kenneth Dittmar has been issued the NPI (National Provider Identifier) 1457447765 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete address where Kenneth Dittmar is physically located?
The Kenneth Dittmar is situated at the following address: 109 Bradford Ave, Fayetteville, NC 283015401.
What is Kenneth Dittmar's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Kenneth Dittmar is Clinical, and the corresponding taxonomy classification code for this specialized field is 103Tc0700X.
On what date did the Kenneth Dittmar receive its 1457447765 assignment from the Centers for Medicare & Medicaid Services?
The Kenneth Dittmar was assigned its 1457447765 by the Centers for Medicare & Medicaid Services on 2006-10-05.
As of what date was the information regarding Kenneth Dittmar, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Kenneth Dittmar, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2010-03-29.
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