Doctor Name: | KATRINA MANN |
NPI Number: | 1043690225 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | LPCCCA00218810 |
Business Practice Address: | 115 Rockwood Ln Hazard, KY - 417019415 |
Business Phone Number: | 6064365761 |
Business Fax Number: | 6064365797 |
Mailing Address: | 115 Rockwood Ln, HAZARD |
State: | KY |
Postal Code: | 417019415 |
Phone Number: | 6064365761 |
Fax Number: | 6064365797 |
NPI Enumeration Date: | 06/03/2015 |
NPI Last Update Date: | 06/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPCCCA00218810 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |