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NPI Code Detail

MEDICARE: MS. KATHRYN GRACE KLANCHER

MEDICARE: MS. KATHRYN GRACE KLANCHER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2101YM0800XMental Health CounselorC.2103245OH

General Provider Information

NPI Number : 1245887918
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHRYN GRACE KLANCHER
Provider Business Mailing Address
First Line : 24500 CENTER RIDGE RD STE 395
Second Line :
City : WESTLAKE
State : OH
Zip : 44145-5631
Country : US
Telephone Number : 440-445-9125
Fax Number :
Provider Business Practice Location Address
First Line : 24500 CENTER RIDGE RD STE 395
Second Line :
City : WESTLAKE
State : OH
Zip : 44145-5631
Country : US
Telephone Number : 440-445-9125
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2019
Last Update Date : 08/10/2021

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Directions to “ MS. KATHRYN GRACE KLANCHER ” Practice Location

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