| Doctor Name: | KRISTINE KLUCK |
| NPI Number: | 1225271919 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LICSW, LIMHP, LADC |
| License Number: | 971 |
| Business Practice Address: | 7424 Apennines Drive C/o Fort Riley Asap Fort Riley, KS - 66442 |
| Business Phone Number: | 7852397311 |
| Business Fax Number: | |
| Mailing Address: | 205 Hunter Ave, MANHATTAN |
| State: | KS |
| Postal Code: | 665038008 |
| Phone Number: | 4024701887 |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2009 |
| NPI Last Update Date: | 03/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 971 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NE |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |