Doctor Name: | MARY LANG KLINE |
NPI Number: | 1003080383 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNS,APRN |
License Number: | 101 0019205 |
Business Practice Address: | 215 N Main St White River Junction, VT - 050090001 |
Business Phone Number: | 8022959363 |
Business Fax Number: | |
Mailing Address: | 215 N Main St, WHITE RIVER JUNCTION |
State: | VT |
Postal Code: | 050090001 |
Phone Number: | 8022959363 |
Fax Number: | |
NPI Enumeration Date: | 04/17/2008 |
NPI Last Update Date: | 01/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0810X |
License Number: | 101 0019205 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Psych/Mental Health, Child & Family |
Taxonomy Definition: |