Provider Demographics
NPI:1588257851
Name:KLEIN, MELANIE RACHAEL (PHD)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:RACHAEL
Last Name:KLEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 WOODSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-2333
Mailing Address - Country:US
Mailing Address - Phone:484-716-8989
Mailing Address - Fax:
Practice Address - Street 1:416 WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2333
Practice Address - Country:US
Practice Address - Phone:484-716-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019171103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent