Individual
DR. CHRISTINA MARIE KEPHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, HSPP
Contact information
Practice address
413 W HOWE ST, BLOOMINGTON, IN 47403-2363
(317) 417-0694
Mailing address
PO BOX 501, CLEAR CREEK, IN 47426-0501
(317) 417-0694
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041960A
IN
Other
Enumeration date
08/12/2010
Last updated
08/12/2010
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