Healthcare Provider Details

I. General information

NPI: 1982666335
Provider Name (Legal Business Name): WAYNE L. KLEIN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 POND ST
FRANKLIN MA
02038-2724
US

IV. Provider business mailing address

741 POND ST
FRANKLIN MA
02038-2724
US

V. Phone/Fax

Practice location:
  • Phone: 617-512-9166
  • Fax:
Mailing address:
  • Phone: 617-512-9166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number6368
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: