Provider Demographics
NPI:1861529695
Name:KAHL, MICHELLE L (MA)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:KAHL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:L
Other - Last Name:KAHL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:115 MABON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-1412
Mailing Address - Country:US
Mailing Address - Phone:814-849-4906
Mailing Address - Fax:814-849-4975
Practice Address - Street 1:115 MABON ST
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-1412
Practice Address - Country:US
Practice Address - Phone:814-849-4906
Practice Address - Fax:814-849-4975
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007190101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional