Provider Demographics
NPI:1528408226
Name:KLEIN, PATRIZIA (PSYD, LPC)
Entity Type:Individual
Prefix:
First Name:PATRIZIA
Middle Name:
Last Name:KLEIN
Suffix:
Gender:F
Credentials:PSYD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 MAIN ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4538
Mailing Address - Country:US
Mailing Address - Phone:203-244-5453
Mailing Address - Fax:
Practice Address - Street 1:412 MAIN ST
Practice Address - Street 2:SUITE 10
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4538
Practice Address - Country:US
Practice Address - Phone:203-244-5453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002115101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor