Provider Demographics
NPI:1891843959
Name:VON KLEMPERER, BARBARA SHANER (EDD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:SHANER
Last Name:VON KLEMPERER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 COLONIAL RD
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-4702
Mailing Address - Country:US
Mailing Address - Phone:908-522-1008
Mailing Address - Fax:908-598-1995
Practice Address - Street 1:140 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1737
Practice Address - Country:US
Practice Address - Phone:908-522-1008
Practice Address - Fax:908-698-0414
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2086103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
746447Medicare ID - Type Unspecified