Individual
DR. DEBRA L. KLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, HSPP
Contact information
Practice address
2100 N MAIN ST STE 304, CROWN POINT, IN 46307-1877
(574) 546-1900
(574) 546-1999
Mailing address
PO BOX 10299, FORT WAYNE, IN 46851-0299
(574) 546-1900
(574) 546-1999
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20043408A
IN
103TC0700X
Clinical Psychologist
20043408A
IN
103TC1900X
Counseling Psychologist
20043408A
IN
225700000X
Massage Therapist
MT21906913
IN
Other
Enumeration date
10/13/2020
Last updated
10/16/2020
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