Provider Demographics
NPI:1689053944
Name:DURI, KLODJANA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KLODJANA
Middle Name:
Last Name:DURI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 JONES RD
Mailing Address - Street 2:
Mailing Address - City:GULPH MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19428-2617
Mailing Address - Country:US
Mailing Address - Phone:267-401-3220
Mailing Address - Fax:
Practice Address - Street 1:1007 JONES RD
Practice Address - Street 2:
Practice Address - City:GULPH MILLS
Practice Address - State:PA
Practice Address - Zip Code:19428-2617
Practice Address - Country:US
Practice Address - Phone:267-401-3220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017818174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist