Healthcare Provider Details

I. General information

NPI: 1861530826
Provider Name (Legal Business Name): GEORGE FREDERICK KLEMPERER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 FRONT ST
BEREA OH
44017-1716
US

IV. Provider business mailing address

429 FRONT ST
BEREA OH
44017-1716
US

V. Phone/Fax

Practice location:
  • Phone: 440-234-1900
  • Fax: 440-234-2072
Mailing address:
  • Phone: 440-234-1900
  • Fax: 440-234-2072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4233
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: