Provider Demographics
NPI:1386411171
Name:SINES, KALYN (LBS)
Entity type:Individual
Prefix:
First Name:KALYN
Middle Name:
Last Name:SINES
Suffix:
Gender:F
Credentials:LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 HARTZELL AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-5431
Mailing Address - Country:US
Mailing Address - Phone:814-327-7374
Mailing Address - Fax:
Practice Address - Street 1:120 BYRON AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4106
Practice Address - Country:US
Practice Address - Phone:814-201-2773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA006849103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst