Provider Demographics
NPI:1013032747
Name:KLINE, SUZANNE JANE (PSYCHOLOGIST)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:JANE
Last Name:KLINE
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 N CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19526-1418
Mailing Address - Country:US
Mailing Address - Phone:714-402-4325
Mailing Address - Fax:
Practice Address - Street 1:770 ZION CHURCH RD
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526-8405
Practice Address - Country:US
Practice Address - Phone:714-402-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28524106H00000X
PAPS006603L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist