Doctor Name: | KATHERINE A. GEORGIC |
NPI Number: | 1093764771 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BS |
License Number: | 6187 |
Business Practice Address: | 1023 Cty Rd 610 Granby, CO - 80446 |
Business Phone Number: | 9708872179 |
Business Fax Number: | 9708879311 |
Mailing Address: | Po Box 40, GLENWOOD SPRINGS |
State: | CO |
Postal Code: | 816020040 |
Phone Number: | 9709452241 |
Fax Number: | 9709455523 |
NPI Enumeration Date: | 05/09/2006 |
NPI Last Update Date: | 01/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 6187 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |