Provider Demographics
NPI:1861796955
Name:KUEHL, GREGG (PHD)
Entity type:Individual
Prefix:DR
First Name:GREGG
Middle Name:
Last Name:KUEHL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 S MORRISON RD
Mailing Address - Street 2:114
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-4043
Mailing Address - Country:US
Mailing Address - Phone:765-216-7792
Mailing Address - Fax:
Practice Address - Street 1:405 S MORRISON RD
Practice Address - Street 2:114
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-4043
Practice Address - Country:US
Practice Address - Phone:765-216-7792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042423A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist