Provider Demographics
NPI:1255573101
Name:WATKINS, KATHRYN ELIZABETH (MSW)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:WATKINS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 N RATH AVE
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-1664
Mailing Address - Country:US
Mailing Address - Phone:231-794-8402
Mailing Address - Fax:
Practice Address - Street 1:319 N RATH AVE
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-1664
Practice Address - Country:US
Practice Address - Phone:231-794-8402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health