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719 Jadwin Ave Unit 719-11 Richland WA 99352-4217 | |
(509) 214-1894 | |
Not Available |
Full Name | |
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Speciality | Psychologist |
Location | 719 Jadwin Ave Unit 719-11, Richland, Washington |
Authorized Official Name and Position | Angela Klingensmith (PSYCHOLOGIST/OWNER) |
Authorized Official Contact | 5092141894 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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719 Jadwin Ave Unit 719-11 Richland WA 99352-4217 Ph: () - | 719 Jadwin Ave Unit 719-11 Richland WA 99352-4217 Ph: (509) 214-1894 |
NPI Number | 1720852429 |
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Provider Enumeration Date | 11/13/2023 |
Last Update Date | 09/16/2024 |
Certification Date | 09/16/2024 |
Medicare PECOS PAC ID | 3173962677 |
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Medicare Enrollment ID | O20240417000692 |
Identifier | Type | State | Issuer |
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1720852429 | NPI | - | NPPES |
Provider Name | Angela R Klingensmith |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1962926485 PECOS PAC ID: 3072933654 Enrollment ID: I20210304002558 |
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