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General NPI Number Information
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NPI Number | 1679351043
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Entity Type | Individual
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Provider Name | RICHARD TEMPLE KLEIN III EDS
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Gender | Male
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Dates
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Enumeration Date | 09/18/2023
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 5301 N FEDERAL HWY STE 370
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City | BOCA RATON
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State | FL
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Zip | 33487-4910
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Country | US
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Telephone | 561-203-9812
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Fax |
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Provider Business Mailing Address
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Address Line | 1640 NE 5TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-1324
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Country | US
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Telephone | 773-490-9301
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | SS1756
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License Number State | FL
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