Provider Demographics
NPI:1316013915
Name:KLEIN HERNANDEZ, ISOBEL P (PHD)
Entity type:Individual
Prefix:
First Name:ISOBEL
Middle Name:P
Last Name:KLEIN HERNANDEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ISOBEL
Other - Middle Name:
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:510 W COURT
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005
Mailing Address - Country:US
Mailing Address - Phone:505-524-2980
Mailing Address - Fax:505-524-2980
Practice Address - Street 1:427 N REYMOND
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005
Practice Address - Country:US
Practice Address - Phone:505-524-2980
Practice Address - Fax:505-524-2980
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0814103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM101316OtherVALUE OPTIONS
NM29227879Medicaid
NM00005OtherVALUE OPTIONS