Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PS006331L | PA |
N | 103T00000X | Psychologist | PS006331L | PA |
Y | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1073693214 |
---|---|
Provider Name | Catherine M Klosek |
First Address | Allentown, PA 18102-4636 |
Second Address | Allentown, PA 18102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 08/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PS006331L | COMMONWEALTH OF PENNSYLVANIA (01) | PA |
PS006331L | LICENSE (01) | PA |