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General NPI Number Information
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NPI Number | 1497685424
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Entity Type | Individual
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Provider Name | DSHUNDRIA LYNN KLECKLEY
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Gender | Female
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Dates
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Enumeration Date | 05/21/2026
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Last Update Date | 05/21/2026
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Provider Practice Location Address
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Address Line | 331 GENEVA RD
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City | BUENA VISTA
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State | GA
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Zip | 31803-1701
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Country | US
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Telephone | 404-319-6094
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Fax | 404-500-0640
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Provider Business Mailing Address
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Address Line | 331 GENEVA RD
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City | BUENA VISTA
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State | GA
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Zip | 31803-1701
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Country | US
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Telephone | 404-319-6094
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Fax | 404-500-0640
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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