Provider Demographics
NPI:1881179745
Name:KLABUNDE, JENA LEE
Entity Type:Individual
Prefix:
First Name:JENA
Middle Name:LEE
Last Name:KLABUNDE
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 1:5313 WIMBERLEY SPRING CT
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-3210
Mailing Address - Country:US
Mailing Address - Phone:281-798-0567
Mailing Address - Fax:
Practice Address - Street 1:2701 N A ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-6611
Practice Address - Country:US
Practice Address - Phone:432-695-9913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst