Provider Information for 1508638560
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KAITLYNN TIMKO NCC,LPC
Sex: Female
NPI: 1508638560
Last Updated: 2023-10-24
Certification Date: 2023-10-24
Certification Date: 2023-10-24
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1508638560 | ||||||||
| Enumeration Date | 2023-10-24 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1200 W COLLEGE AVE STATE COLLEGE, PA 16801-2824 United States Phone: 814-325-0280 | Fax:814-826-2241 | ||||||||
| Primary Practice Address | 1200 W COLLEGE AVE STATE COLLEGE, PA 16801-2824 United States Phone: 814-325-0280 | Fax:814-826-2241 | ||||||||
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