Provider Demographics
NPI:1962053934
Name:KLEE, EUDORA
Entity type:Individual
Prefix:
First Name:EUDORA
Middle Name:
Last Name:KLEE
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 1:1225 WHITEHORSE MERCERVILLE RD BLDG B504
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3882
Mailing Address - Country:US
Mailing Address - Phone:609-256-4200
Mailing Address - Fax:609-581-1623
Practice Address - Street 1:1225 WHITEHORSE MERCERVILLE RD BLDG B504
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3882
Practice Address - Country:US
Practice Address - Phone:609-256-4200
Practice Address - Fax:609-581-1623
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-21
Last Update Date:2019-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator