Provider Demographics
NPI:1124808746
Name:KIM KOBUS PHD
Entity type:Organization
Organization Name:KIM KOBUS PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KARAGANIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:907-313-9118
Mailing Address - Street 1:PO BOX 190003
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99519-0003
Mailing Address - Country:US
Mailing Address - Phone:630-585-3988
Mailing Address - Fax:630-585-3988
Practice Address - Street 1:205 E BENSON BLVD STE 518
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4019
Practice Address - Country:US
Practice Address - Phone:907-313-9118
Practice Address - Fax:630-585-3988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty