Provider Demographics
NPI:1023716891
Name:HIGH, KATRINA VALERIE
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:VALERIE
Last Name:HIGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 E WELLINGTON MEWS
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-3901
Mailing Address - Country:US
Mailing Address - Phone:732-492-2081
Mailing Address - Fax:
Practice Address - Street 1:28 E MOUNT VERNON ST STE 103
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1484
Practice Address - Country:US
Practice Address - Phone:302-278-0052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician