Provider Demographics
NPI:1992841571
Name:KLEINMAN, RUDITE MARA (PHD)
Entity Type:Individual
Prefix:DR
First Name:RUDITE
Middle Name:MARA
Last Name:KLEINMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:R
Other - Middle Name:MARA
Other - Last Name:KLEINMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:4422 CARVER WOODS DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242
Mailing Address - Country:US
Mailing Address - Phone:513-984-2800
Mailing Address - Fax:513-984-2844
Practice Address - Street 1:4422 CARVER WOODS DR
Practice Address - Street 2:MONTGOMERY PROFESSIONAL ASSOC INC
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242
Practice Address - Country:US
Practice Address - Phone:513-984-2800
Practice Address - Fax:513-984-2844
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2232103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical