Individual
SAMANTHA LYNN KLOCKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LP
Contact information
Practice address
4131 W LOOMIS RD APT 120, GREENFIELD, WI 53221-2006
(414) 424-2445
(414) 424-2446
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3983-57
WI
103TC0700X
Clinical Psychologist
6493
MN
Other
Enumeration date
09/28/2017
Last updated
07/22/2025
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