Provider Demographics
NPI:1770709453
Name:KLEIN, DONALD L (PHD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:L
Last Name:KLEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:PROF
Other - First Name:DONALD
Other - Middle Name:L
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYCHOLOGIST
Mailing Address - Street 1:2 GARVIN RD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:PA
Mailing Address - Zip Code:17517-9407
Mailing Address - Country:US
Mailing Address - Phone:717-336-2665
Mailing Address - Fax:
Practice Address - Street 1:2 GARVIN RD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:PA
Practice Address - Zip Code:17517-9407
Practice Address - Country:US
Practice Address - Phone:717-336-2665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015293103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent