Provider Demographics
NPI:1326268582
Name:KLEPPER, LINDA DIANE (LLP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:DIANE
Last Name:KLEPPER
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17321 M60 EAST
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:MI
Mailing Address - Zip Code:49095
Mailing Address - Country:US
Mailing Address - Phone:269-476-9781
Mailing Address - Fax:
Practice Address - Street 1:17321 M60 EAST
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:MI
Practice Address - Zip Code:49095
Practice Address - Country:US
Practice Address - Phone:269-476-9781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010909103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)