Individual
LEWIS BERNARD KLEBANOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
32 SIMMONS POND RD W, DENNIS, MA 02638-2541
(508) 385-6813
(508) 385-6813
Mailing address
32 SIMMONS POND RD W, DENNIS, MA 02638-2541
(508) 385-6813
(508) 385-6813
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
675
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W01777
BCBS
MA
Enumeration date
08/01/2006
Last updated
07/08/2007
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