Provider Demographics
NPI:1457833188
Name:KLEINERMAN, INBAL (PHD)
Entity Type:Individual
Prefix:
First Name:INBAL
Middle Name:
Last Name:KLEINERMAN
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 1:508 DEEP EDDY AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-4555
Mailing Address - Country:US
Mailing Address - Phone:512-469-0889
Mailing Address - Fax:512-469-6002
Practice Address - Street 1:3006 BEE CAVES RD STE D310
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5753
Practice Address - Country:US
Practice Address - Phone:512-469-0889
Practice Address - Fax:512-469-6002
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37884103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty