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General NPI Number Information
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NPI Number | 1336112093
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Entity Type | Organization
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Legal Business Name | PAMELA S KLONOFF PHD PLLC
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 04/07/2011
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Provider Practice Location Address
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Address Line | 222 W THOMAS RD SUITE 401
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City | PHOENIX
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State | AZ
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Zip | 85013-4419
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Country | US
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Telephone | 602-406-3473
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27340
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City | PHOENIX
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State | AZ
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Zip | 85061-7340
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Country | US
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Telephone | 602-943-9200
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Fax | 602-216-3000
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAMELA S KLONOFF
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Credential | PHD
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Telephone | 602-406-3473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 1239
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License Number State | AZ
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