Provider Demographics
NPI:1275593691
Name:KLINGLER, JILL R (PHD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:R
Last Name:KLINGLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6223 ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45213-1101
Mailing Address - Country:US
Mailing Address - Phone:513-478-9434
Mailing Address - Fax:513-621-3240
Practice Address - Street 1:6223 ORCHARD LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45213-1101
Practice Address - Country:US
Practice Address - Phone:513-478-9434
Practice Address - Fax:513-621-3240
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5758103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9340951Medicare PIN