Provider Demographics
NPI:1164301610
Name:KLEINSTAEUBER, MARIA (PHD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:KLEINSTAEUBER
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 1:351 E 600 S
Mailing Address - Street 2:
Mailing Address - City:RIVER HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84321-5523
Mailing Address - Country:US
Mailing Address - Phone:801-357-9113
Mailing Address - Fax:
Practice Address - Street 1:6405 OLD MAIN HILL
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84322-6405
Practice Address - Country:US
Practice Address - Phone:435-797-4200
Practice Address - Fax:844-308-5865
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14188904-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist