Provider Demographics
NPI:1780451856
Name:KLINGER, SHIRA (MRWP, FNTP, LMT, CPT)
Entity type:Individual
Prefix:
First Name:SHIRA
Middle Name:
Last Name:KLINGER
Suffix:
Gender:
Credentials:MRWP, FNTP, LMT, CPT
Other - Prefix:
Other - First Name:ZEPHYR
Other - Middle Name:SHIRA
Other - Last Name:KLINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MRWP, FNTP, LMT, CPT
Mailing Address - Street 1:819 BOND ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-3567
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8827 SOUTHWICK ST
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-3234
Practice Address - Country:US
Practice Address - Phone:571-544-2016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-07
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM6801225700000X
171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty