Provider Demographics
NPI:1154627768
Name:KLAPHAAK, PATTY S
Entity Type:Individual
Prefix:MRS
First Name:PATTY
Middle Name:S
Last Name:KLAPHAAK
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 1:2220 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-2335
Mailing Address - Country:US
Mailing Address - Phone:502-386-3367
Mailing Address - Fax:502-742-2889
Practice Address - Street 1:2220 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-2335
Practice Address - Country:US
Practice Address - Phone:502-386-3367
Practice Address - Fax:502-742-2889
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist