Provider Demographics
NPI:1578829032
Name:KLEHR, CAROLYN CLARA (PSYD, LP)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:CLARA
Last Name:KLEHR
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 394
Mailing Address - Street 2:
Mailing Address - City:DETROIT LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:56502-0394
Mailing Address - Country:US
Mailing Address - Phone:218-847-8572
Mailing Address - Fax:218-847-6113
Practice Address - Street 1:1339 PELICAN LN
Practice Address - Street 2:
Practice Address - City:DETROIT LAKES
Practice Address - State:MN
Practice Address - Zip Code:56501-2726
Practice Address - Country:US
Practice Address - Phone:218-847-8572
Practice Address - Fax:218-847-6113
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5482103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical