Doctor Name: | MS. KATHRYN EVERSON |
NPI Number: | 1033427836 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 4826-125 |
Business Practice Address: | 1500 N 34th St Superior, WI - 548804477 |
Business Phone Number: | 7153928216 |
Business Fax Number: | 7153926055 |
Mailing Address: | 1401 East First Street, DULUTH |
State: | MN |
Postal Code: | 55805 |
Phone Number: | 2187284491 |
Fax Number: | 2187284404 |
NPI Enumeration Date: | 09/15/2010 |
NPI Last Update Date: | 07/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4826-125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |