Provider Demographics
NPI:1003252883
Name:KLINE, KATHERINE MARJORIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:MARJORIE
Last Name:KLINE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 BECKLEY PL
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-1030
Mailing Address - Country:US
Mailing Address - Phone:517-256-4920
Mailing Address - Fax:
Practice Address - Street 1:377 BECKLEY PL
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-1030
Practice Address - Country:US
Practice Address - Phone:517-256-4920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013008779101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional