Provider Demographics
NPI:1881268142
Name:KLINGLER, KESLA B
Entity type:Individual
Prefix:
First Name:KESLA
Middle Name:B
Last Name:KLINGLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:HOLLANSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45332-0145
Mailing Address - Country:US
Mailing Address - Phone:937-621-6900
Mailing Address - Fax:
Practice Address - Street 1:204 N BARRON ST
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-1765
Practice Address - Country:US
Practice Address - Phone:937-456-2805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2101802-TRNE104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker