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Individual

MR. STEFFEN RENE KLOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1808 HIGHWAY 190 W STE C2, DERIDDER, LA 70634-6023
(337) 348-0842
Mailing address
267 COUNTY LINE RD, DERIDDER, LA 70634-6130

Taxonomy

Speciality
Code
Description
License number
State
103TH0004X
Health Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
777000318044901
LA
Enumeration date
08/31/2017
Last updated
08/31/2017
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