Provider Demographics
NPI:1275935736
Name:KLEIN, STEPHANIE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 UPLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401
Mailing Address - Country:US
Mailing Address - Phone:215-873-6459
Mailing Address - Fax:
Practice Address - Street 1:915 UPLAND RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-7549
Practice Address - Country:US
Practice Address - Phone:215-873-6459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7310133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered