Provider Demographics
NPI:1902838642
Name:KLAUS, JOHANNA RIVERS (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:RIVERS
Last Name:KLAUS
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 1:423 BLUE RD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2103
Mailing Address - Country:US
Mailing Address - Phone:305-582-0325
Mailing Address - Fax:
Practice Address - Street 1:1508 SAN IGNACIO AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3062
Practice Address - Country:US
Practice Address - Phone:305-582-0325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7337103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical