MEDICARE: DR. CAROL L KLEIN ED D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist		PA

General Provider Information

NPI Number	:	1801881263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL L KLEIN ED D

Provider Business Mailing Address
First Line	:	105 HOLLYHOCK DR
Second Line	:
City	:	LAFAYETTE HILL
State	:	PA
Zip	:	19444-2105
Country	:	US
Telephone Number	:	610-825-4122
Fax Number	:	610-825-9056

Provider Business Practice Location Address
First Line	:	105 HOLLYHOCK DR
Second Line	:
City	:	LAFAYETTE HILL
State	:	PA
Zip	:	19444-2105
Country	:	US
Telephone Number	:	610-825-4122
Fax Number	:	610-825-9056

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	07/08/2007

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