| Doctor Name: | KATHIE RAE WATERS |
| NPI Number: | 1447671359 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | 4913 |
| Business Practice Address: | 47177 Us Hwy 2 West Lower Level Suite 1 Malta, MT - 59538 |
| Business Phone Number: | 4063901916 |
| Business Fax Number: | |
| Mailing Address: | Po Box 284, MALTA |
| State: | MT |
| Postal Code: | 595380284 |
| Phone Number: | 4066541539 |
| Fax Number: | |
| NPI Enumeration Date: | 12/18/2013 |
| NPI Last Update Date: | 07/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 4913 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |