Provider Demographics
NPI:1114655461
Name:KLEEN, BATYA BARBARA
Entity type:Individual
Prefix:
First Name:BATYA
Middle Name:BARBARA
Last Name:KLEEN
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 1:2817 COLORADO AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1826
Mailing Address - Country:US
Mailing Address - Phone:303-907-8656
Mailing Address - Fax:
Practice Address - Street 1:2817 COLORADO AVE S
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1826
Practice Address - Country:US
Practice Address - Phone:303-907-8656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU03099171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist