Provider Demographics
NPI:1134386444
Name:KLEINMAN, LORI I (PHD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:I
Last Name:KLEINMAN
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 1:824 BAY ST NE
Mailing Address - Street 2:APT. B
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-2544
Mailing Address - Country:US
Mailing Address - Phone:813-340-0414
Mailing Address - Fax:
Practice Address - Street 1:824 BAY ST NE
Practice Address - Street 2:APT. B
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-2544
Practice Address - Country:US
Practice Address - Phone:813-340-0414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6734103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist