Provider Demographics
NPI:1871323899
Name:KLEM, ROBERT
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:KLEM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3481 SHOVEE CT
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-3116
Mailing Address - Country:US
Mailing Address - Phone:772-359-7544
Mailing Address - Fax:
Practice Address - Street 1:3481 SHOVEE CT
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-3116
Practice Address - Country:US
Practice Address - Phone:772-359-7544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker