Individual
DR. KIMBERLY SUE VANHAITSMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
1425 HORSHAM RD, NORTH WALES, PA 19454-1320
(215) 371-1895
(215) 371-3015
Mailing address
388 COBBLER CT, YARDLEY, PA 19067-4752
(215) 371-1895
(215) 371-3015
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS006311L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01539769
—
PA
Enumeration date
04/16/2009
Last updated
04/16/2009
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