Doctor Name: | HALEY KLIEFOTH |
NPI Number: | 1639546807 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 1554LCPC |
Business Practice Address: | 631 Willow Creek Rd Leicester, NC - 287485646 |
Business Phone Number: | 8283180148 |
Business Fax Number: | |
Mailing Address: | 631 Willow Creek Rd, LEICESTER |
State: | NC |
Postal Code: | 287485646 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/24/2015 |
NPI Last Update Date: | 08/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1554LCPC |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |