Provider Demographics
NPI:1881660868
Name:KLEE, MICHELLE R (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:R
Last Name:KLEE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-3630
Mailing Address - Country:US
Mailing Address - Phone:269-267-8978
Mailing Address - Fax:269-375-6078
Practice Address - Street 1:2215 S PARK ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-3630
Practice Address - Country:US
Practice Address - Phone:269-267-8978
Practice Address - Fax:269-375-6078
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006205103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIR65995Medicare UPIN
OM91630Medicare ID - Type Unspecified