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General NPI Number Information
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NPI Number | 1902327976
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Entity Type | Organization
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Legal Business Name | JACQUELINE KLAVER PHD, PLLC
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2200 21ST AVE S STE 300
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City | NASHVILLE
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State | TN
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Zip | 37212-4929
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Country | US
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Telephone | 615-933-3571
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 21ST AVE S STE 300
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City | NASHVILLE
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State | TN
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Zip | 37212-4929
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Country | US
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Telephone | 615-933-3571
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC NEUROPSYCHOLOGIST
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Name | JACQUELINE KLAVER
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Credential | PHD
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Telephone | 615-933-3571
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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 | 3364
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License Number State | TN
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