Healthcare Provider Details
I. General information
NPI: 1205068087
Provider Name (Legal Business Name): VIRGINIA M. KLEMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/13/2009
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1403 S GRAND BLVD STE 203N
SPOKANE WA
99203-2200
US
IV. Provider business mailing address
1403 S GRAND BLVD STE 203N
SPOKANE WA
99203-2200
US
V. Phone/Fax
- Phone: 509-779-8065
- Fax: 844-779-0338
- Phone: 509-779-8065
- Fax: 844-779-0338
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | PY60562243 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: