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General NPI Number Information
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NPI Number | 1194940908
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Entity Type | Organization
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Legal Business Name | NANCI C. KLEIN, PH.D., INC.
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 505 E 200 S SUITE 303
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-2022
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Country | US
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Telephone | 801-350-0116
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Fax | 801-350-9582
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Provider Business Mailing Address
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Address Line | 505 E 200 S SUITE 303
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-2022
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Country | US
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Telephone | 801-350-0116
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Fax | 801-350-9582
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NANCI CAROL KLEIN
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Credential | PH.D.
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Telephone | 801-350-0116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1139762501
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License Number State | UT
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