Provider Information for 1265023352
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JANE EMILY KLINGBERG Counselor
Sex: Female
NPI: 1265023352
Last Updated: 2025-02-25
Certification Date: 2025-02-25
Certification Date: 2025-02-25
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1265023352 | ||||||||||||||||||||
| Enumeration Date | 2021-02-01 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 5756 N YOSEMITE LN APPLETON, WI 54913-2734 United States Phone: | Fax: | ||||||||||||||||||||
| Primary Practice Address | 1620 S LAWE ST STE 1 APPLETON, WI 54915-2419 United States Phone: 920-284-9676 | Fax:920-481-3121 | ||||||||||||||||||||
| Secondary Practice Address(es) | 843 HIGHLAND AVE | ||||||||||||||||||||
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