Individual
THOMAS EDWARD KLECKER
Active
Individual
THOMAS EDWARD KLECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW LP
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1802
MN
1041C0700X
Clinical Social Worker
LICSW2045
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6268607
MEDICA
MN
01
—
69658KL
BLUE CROSS
MN
Enumeration date
11/27/2007
Last updated
11/27/2007
Update your record
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