Provider Demographics
NPI:1235335159
Name:KLINGER, ANNE WATERMAN (MS,LPC,NCC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:WATERMAN
Last Name:KLINGER
Suffix:
Gender:F
Credentials:MS,LPC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 E CHESTNUT HILL AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-2715
Mailing Address - Country:US
Mailing Address - Phone:215-247-4067
Mailing Address - Fax:215-753-8725
Practice Address - Street 1:22 E CHESTNUT HILL AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-2715
Practice Address - Country:US
Practice Address - Phone:215-247-4067
Practice Address - Fax:215-753-8725
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA000410101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional