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NPI Code Detail

MEDICARE: MS. KAY F KLINKENBERG LMFT

MEDICARE:  MS. KAY F KLINKENBERG  LMFT
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
1106H00000XMarriage & Family TherapistIL

General Provider Information

NPI Number : 1487759148
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAY F KLINKENBERG LMFT
Provider Business Mailing Address
First Line : 1124 SOUTH FIFTH ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703
Country : US
Telephone Number : 217-744-3525
Fax Number : 217-744-3535
Provider Business Practice Location Address
First Line : 1124 SOUTH FIFTH ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703
Country : US
Telephone Number : 217-744-3525
Fax Number : 217-744-3535
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 07/08/2007

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Directions to “ MS. KAY F KLINKENBERG LMFT” Practice Location

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