Doctor Name: | DALE ROBIN KLEIN-KENNEDY |
NPI Number: | 1366604498 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | 0074381 |
Business Practice Address: | 10709 Cielo Vista Del Norte Corrales, NM - 870488905 |
Business Phone Number: | 5053504237 |
Business Fax Number: | 5058439520 |
Mailing Address: | 10709 Cielo Vista Del Norte, CORRALES |
State: | NM |
Postal Code: | 870488905 |
Phone Number: | 5053504237 |
Fax Number: | 5058439520 |
NPI Enumeration Date: | 06/30/2008 |
NPI Last Update Date: | 06/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0074381 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |