Basic Information
| Provider Information | |||||||||
| NPI: | 1306205307 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DULA-KLONTZ | ||||||||
| FirstName: | SASKIA | ||||||||
| MiddleName: | G. E. | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5005 N. PIEDRAS STREET | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9157426382 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5005 N. PIEDRAS STREET | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9157426382 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2016 | ||||||||
| LastUpdateDate: | 04/20/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | C011423 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 18809 | MD | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.