Individual
JOHN KIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
19 E ELIZABETH AVE, BETHLEHEM, PA 18018-6520
(610) 865-1699
(610) 419-3446
Mailing address
19 E ELIZABETH AVE, BETHLEHEM, PA 18018-6520
(610) 865-1699
(610) 419-3446
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
542083365
—
PA
Enumeration date
01/22/2016
Last updated
01/22/2016
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