Provider Demographics
NPI:1548351067
Name:KLIMP, GINA P (PSYD)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:P
Last Name:KLIMP
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:GINA
Other - Middle Name:P
Other - Last Name:WENDLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:3771 RAMSEY ST
Mailing Address - Street 2:SUITE 109243
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-7675
Mailing Address - Country:US
Mailing Address - Phone:910-482-9906
Mailing Address - Fax:
Practice Address - Street 1:700 24TH ST
Practice Address - Street 2:KENNER AHC, COMMUNITY MENTAL HEALTH
Practice Address - City:FORT LEE
Practice Address - State:VA
Practice Address - Zip Code:23801-1716
Practice Address - Country:US
Practice Address - Phone:804-734-9295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7204103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical