Doctor Name: | MRS. KATHERINE A MISTERKA |
NPI Number: | 1134427214 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSSA, LISW-S |
License Number: | I. 1101325 .SUPV |
Business Practice Address: | 347 Midway Blvd Suite 200 Elyria, OH - 440359006 |
Business Phone Number: | 4407235494 |
Business Fax Number: | 4403249978 |
Mailing Address: | 347 Midway Blvd, Suite 200 ELYRIA |
State: | OH |
Postal Code: | 440359006 |
Phone Number: | 4407235494 |
Fax Number: | 4403249978 |
NPI Enumeration Date: | 03/14/2011 |
NPI Last Update Date: | 02/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I. 1101325 .SUPV |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |