Provider Demographics
NPI:1225285331
Name:MICHELLE H KLINGER LMW
Entity Type:Organization
Organization Name:MICHELLE H KLINGER LMW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:H
Authorized Official - Last Name:KLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-210-0523
Mailing Address - Street 1:30445 W 14 MILE RD APT 70
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1549
Mailing Address - Country:US
Mailing Address - Phone:248-210-0523
Mailing Address - Fax:
Practice Address - Street 1:31700 W 13 MILE RD
Practice Address - Street 2:SUITE 219
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2166
Practice Address - Country:US
Practice Address - Phone:248-210-0523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801078103261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health