Provider Demographics
NPI:1114130515
Name:KLEIN, RICHARD A (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:KLEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8711 E.PINNACLE PEAK RD., #261
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3517
Mailing Address - Country:US
Mailing Address - Phone:602-418-9084
Mailing Address - Fax:
Practice Address - Street 1:8711 E.PINNACLE PEAK RD., #261
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3517
Practice Address - Country:US
Practice Address - Phone:602-418-9084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2082103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341202615-00OtherWORKERS COMPENSATION
OH341202615-00OtherWORKERS COMPENSATION