Provider Demographics
NPI:1801039425
Name:DUKE-KLOSS, MICHELLE (MHS)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:DUKE-KLOSS
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:DUKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MHS
Mailing Address - Street 1:4400 S CEDARBROOK RD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6002
Mailing Address - Country:US
Mailing Address - Phone:610-481-0444
Mailing Address - Fax:
Practice Address - Street 1:4400 S CEDARBROOK RD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6002
Practice Address - Country:US
Practice Address - Phone:610-481-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)