Provider Demographics
NPI:1538816970
Name:HOBSON, KATHLEEN TIFFANIE
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:TIFFANIE
Last Name:HOBSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 N HIGH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-1098
Mailing Address - Country:US
Mailing Address - Phone:570-269-1645
Mailing Address - Fax:
Practice Address - Street 1:180 S BROADWAY STE 400
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1820
Practice Address - Country:US
Practice Address - Phone:347-543-4726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-06
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health