Provider Demographics
NPI:1710726286
Name:KLYNE, AURORA ROSE
Entity type:Individual
Prefix:
First Name:AURORA
Middle Name:ROSE
Last Name:KLYNE
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 1:2960 CHAIN BRIDGE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124
Mailing Address - Country:US
Mailing Address - Phone:703-490-0336
Mailing Address - Fax:
Practice Address - Street 1:2960 CHAIN BRIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:OAKTON
Practice Address - State:VA
Practice Address - Zip Code:22124
Practice Address - Country:US
Practice Address - Phone:703-490-0336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health