Healthcare Provider Details

I. General information

NPI: 1457120719
Provider Name (Legal Business Name): HEIDI L KLEIMAN LBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2023
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 RENAISSANCE BLVD STE 105
KING OF PRUSSIA PA
19406-2676
US

IV. Provider business mailing address

1785 BROOK RD
ABINGTON PA
19001-4601
US

V. Phone/Fax

Practice location:
  • Phone: 267-802-1701
  • Fax:
Mailing address:
  • Phone: 267-572-1902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH005345
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: