Provider Demographics
NPI:1093294530
Name:KLEINPETER, ALICIA
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:KLEINPETER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6450 LOUISIANA HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:BATCHELOR
Mailing Address - State:LA
Mailing Address - Zip Code:70715
Mailing Address - Country:US
Mailing Address - Phone:225-492-3775
Mailing Address - Fax:
Practice Address - Street 1:8387 NEWFIELD DR
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:LA
Practice Address - Zip Code:70755-3605
Practice Address - Country:US
Practice Address - Phone:225-637-2323
Practice Address - Fax:225-637-2327
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14808104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker