Doctor Name: | KATHLEEN ANNE FITZWILLIAM |
NPI Number: | 1184048043 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 1193 |
Business Practice Address: | 215 Willard Street Haines, AK - 998270090 |
Business Phone Number: | 9077662177 |
Business Fax Number: | 9077662977 |
Mailing Address: | Po Box 1291, HAINES |
State: | AK |
Postal Code: | 998271291 |
Phone Number: | 8015418242 |
Fax Number: | 9077662977 |
NPI Enumeration Date: | 02/13/2014 |
NPI Last Update Date: | 05/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1193 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |