Provider Demographics
NPI:1568819035
Name:KLAY, PATRICIA (MSED, LPC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:KLAY
Suffix:
Gender:F
Credentials:MSED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2652 MOHICAN AVE
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-3735
Mailing Address - Country:US
Mailing Address - Phone:937-271-2022
Mailing Address - Fax:
Practice Address - Street 1:2652 MOHICAN AVE
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-3735
Practice Address - Country:US
Practice Address - Phone:937-271-2022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-15
Last Update Date:2016-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1600259101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional