Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 6301010909 | MI |
NPI | 1326268582 |
---|---|
Provider Name | Linda Diane Klepper |
First Address | Vandalia, MI 49095 |
Second Address | Vandalia, MI 49095 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2007 |
Last Update Date | 08/07/2007 |