| Doctor Name: | DR. KATHLEEN MARIE CLELAND |
| NPI Number: | 1528039708 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 22398 |
| Business Practice Address: | 3620 Joseph Siewick Dr Suite 406 Fairfax, VA - 220331756 |
| Business Phone Number: | 7033598640 |
| Business Fax Number: | 7035916105 |
| Mailing Address: | 3620 Joseph Siewick Dr, Suite 406 FAIRFAX |
| State: | VA |
| Postal Code: | 220331756 |
| Phone Number: | 7033598640 |
| Fax Number: | 7035916105 |
| NPI Enumeration Date: | 01/27/2006 |
| NPI Last Update Date: | 07/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 22398 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |