Provider Demographics
NPI:1700897766
Name:KLEIN, STEVEN P (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:P
Last Name:KLEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5733 W GRANDE MARKET DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8472
Mailing Address - Country:US
Mailing Address - Phone:920-749-1005
Mailing Address - Fax:920-749-4914
Practice Address - Street 1:5733 W GRANDE MARKET DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8472
Practice Address - Country:US
Practice Address - Phone:920-749-1005
Practice Address - Fax:920-749-4914
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1262103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist