Provider Demographics
NPI:1174593552
Name:PLATONI, KATHERINE THERESA (PSYD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:THERESA
Last Name:PLATONI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-2362
Mailing Address - Country:US
Mailing Address - Phone:937-321-4020
Mailing Address - Fax:937-435-8950
Practice Address - Street 1:50 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-2362
Practice Address - Country:US
Practice Address - Phone:937-321-4020
Practice Address - Fax:937-435-8950
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1432103TC0700X
OH4020103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH087330Medicaid
OH087330Medicaid