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General NPI Number Information
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NPI Number | 1487253985
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Entity Type | Individual
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Provider Name | DR. CELINE MARIE MCNELIS-KLINE
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Gender | Female
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Dates
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Enumeration Date | 10/26/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 455 E EISENHOWER PKWY STE 15
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City | ANN ARBOR
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State | MI
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Zip | 48108-3321
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Country | US
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Telephone | 734-219-9260
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Fax |
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Provider Business Mailing Address
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Address Line | 906 GRANT ST
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City | WAUSAU
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State | WI
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Zip | 54403-4933
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Country | US
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Telephone | 715-432-4570
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 6351004305
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License Number State | MI
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