Provider Demographics
NPI:1538937529
Name:CURTIS, KIRSTEN (PSYD)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:CURTIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 N 12TH ST APT 1008
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1228
Mailing Address - Country:US
Mailing Address - Phone:210-818-1313
Mailing Address - Fax:
Practice Address - Street 1:315 N 12TH ST APT 1008
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1228
Practice Address - Country:US
Practice Address - Phone:210-818-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020284103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical