PAMELA S KLONOFF PHD PLLC
Clinical Neuropsychologist
Phoenix, Arizona
Provider NPI: 1336112093
Organization Information:Organization Name: PAMELA S KLONOFF PHD PLLC
Organization is not Subpart
Authorized Official: PAMELA S KLONOFF PRESIDENT 602-4063473
Practice Location:
222 W THOMAS RD SUITE 401 PHOENIX, AZ 85013 US
Tel: 602-406-3473 Fax: --
Business Mailing Address:
PO BOX 27340 PHOENIX, AZ 85061 US
Tel: 602-943-9200 Fax: 602-216-3000
Entity Type: Organization
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Organization is not Subpart
Authorized Official: PAMELA S KLONOFF PRESIDENT 602-4063473
Practice Location:
222 W THOMAS RD SUITE 401 PHOENIX, AZ 85013 US
Tel: 602-406-3473 Fax: --
Business Mailing Address:
PO BOX 27340 PHOENIX, AZ 85061 US
Tel: 602-943-9200 Fax: 602-216-3000
Entity Type: Organization
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | AZ | 1239 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
731332 | AZ | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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