Individual
DR. KIMBERLY C DEBOER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY. D.
Contact information
Practice address
134 BROAD ST, SUITE 5, STROUDSBURG, PA 18360-1590
(570) 872-9324
(570) 872-9325
Mailing address
134 BROAD ST, SUITE 5, STROUDSBURG, PA 18360-1590
(570) 872-9324
(570) 872-9325
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PC003734
PA
103T00000X
Psychologist
Primary
PS016801
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102070114
—
PA
01
—
601931565
MEDICARE
—
Enumeration date
11/12/2007
Last updated
09/01/2015
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