Provider Demographics
NPI:1629254370
Name:JILL R. KLINGLER, PH.D., INC.
Entity Type:Organization
Organization Name:JILL R. KLINGLER, PH.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:RIEMAN
Authorized Official - Last Name:KLINGLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:513-478-9434
Mailing Address - Street 1:6223 ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45213-1101
Mailing Address - Country:US
Mailing Address - Phone:513-478-9434
Mailing Address - Fax:513-621-3240
Practice Address - Street 1:6223 ORCHARD LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45213-1101
Practice Address - Country:US
Practice Address - Phone:513-478-9434
Practice Address - Fax:513-621-3240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2020-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5758103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHGROUP NO. 9340951Medicare PIN