Doctor Name: | MS. KAYLEEN STIDHAM-KLIER |
NPI Number: | 1023009982 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | E0004408 |
Business Practice Address: | 210 N Main St London, OH - 431401115 |
Business Phone Number: | 7408526256 |
Business Fax Number: | 7408526395 |
Mailing Address: | 210 N Main St, LONDON |
State: | OH |
Postal Code: | 431401115 |
Phone Number: | 7408526256 |
Fax Number: | 7408526395 |
NPI Enumeration Date: | 10/31/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | E0004408 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |