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General NPI Number Information
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NPI Number | 1891218061
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Entity Type | Individual
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Provider Name | LISA KLAMMER MA, LLPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 14165 N FENTON RD STE 204A
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City | FENTON
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State | MI
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Zip | 48430-1186
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Country | US
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Telephone | 810-396-5807
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Fax |
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Provider Business Mailing Address
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Address Line | 14090 WOODVIEW DR
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City | FENTON
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State | MI
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Zip | 48430-3311
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401016090
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License Number State | MI
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