Provider Demographics
NPI:1437277043
Name:KLEINPETER, PRISCILLA JANE (M A , LMFT)
Entity Type:Individual
Prefix:MRS
First Name:PRISCILLA
Middle Name:JANE
Last Name:KLEINPETER
Suffix:
Gender:F
Credentials:M A , LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1901 MEDI PARK DR
Mailing Address - Street 2:#1036
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2110
Mailing Address - Country:US
Mailing Address - Phone:806-352-5542
Mailing Address - Fax:806-352-5597
Practice Address - Street 1:1901 MEDI PARK DR
Practice Address - Street 2:#1036
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2110
Practice Address - Country:US
Practice Address - Phone:806-352-5542
Practice Address - Fax:806-352-5597
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001414-042757106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX209203OtherVALUE OPTIONS