Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | LP1091 | ME |
NPI | 1285744367 |
---|---|
Provider Name | Cheryl L Klein |
First Address | South Windham, ME 04082 |
Second Address | Windham, ME 04062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
026917 | ANTHEM (01) | |
2068071 | CIGNA (01) |