Provider Demographics
NPI:1124338454
Name:DEMOR, KIMBERLY R (LMFT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:R
Last Name:DEMOR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9802 PRESIDENTIAL DR
Mailing Address - Street 2:APT 306
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-1802
Mailing Address - Country:US
Mailing Address - Phone:610-724-5577
Mailing Address - Fax:
Practice Address - Street 1:2611 STAYTON ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-2759
Practice Address - Country:US
Practice Address - Phone:412-605-2819
Practice Address - Fax:412-231-5199
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000581106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist