Provider Demographics
NPI:1487124848
Name:HUSKEY, KATHLEEN N
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:N
Last Name:HUSKEY
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 1:420 E LONGVIEW DR STE B
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-2102
Mailing Address - Country:US
Mailing Address - Phone:920-543-5583
Mailing Address - Fax:
Practice Address - Street 1:420 E LONGVIEW DR STE B
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-2102
Practice Address - Country:US
Practice Address - Phone:920-543-5583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-28
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health