Provider Demographics
NPI:1659662955
Name:KLAAR, KENDRA L
Entity Type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:L
Last Name:KLAAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 N TENAYA WAY
Mailing Address - Street 2:#111
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0600
Mailing Address - Country:US
Mailing Address - Phone:225-571-9669
Mailing Address - Fax:
Practice Address - Street 1:751 N TENAYA WAY
Practice Address - Street 2:#111
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0600
Practice Address - Country:US
Practice Address - Phone:225-571-9669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV225400000XMedicaid