Provider Demographics
NPI:1548476310
Name:KITTLER, KARIN DIANE (MS, AC)
Entity type:Individual
Prefix:MS
First Name:KARIN
Middle Name:DIANE
Last Name:KITTLER
Suffix:
Gender:F
Credentials:MS, AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 STEWART PL
Mailing Address - Street 2:9E
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-3809
Mailing Address - Country:US
Mailing Address - Phone:914-761-7224
Mailing Address - Fax:
Practice Address - Street 1:1931 WILLIAMSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1632
Practice Address - Country:US
Practice Address - Phone:718-829-0601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06000140106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist