Individual
HARRY E KLEBANOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
115 MAIN ST, SUITE 2D, NORTH EASTON, MA 02356-1468
(508) 238-7766
(508) 230-5089
Mailing address
115 MAIN ST STE 2D, NORTH EASTON, MA 02356-1469
(508) 238-7766
(508) 230-5089
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1796
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1899317
—
MA
01
—
712921
TUFTS HEALTH PLAN
MA
01
—
WO1950
BC BS OF MASSACHUSETTS
MA
Enumeration date
06/12/2006
Last updated
10/25/2010
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