Healthcare Provider Details

I. General information

NPI: 1386154805
Provider Name (Legal Business Name): KATRINA MARIE STEINER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATRINA MARIE CZAJKOWSKI

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8444 N 90TH ST STE 100
SCOTTSDALE AZ
85258-4437
US

IV. Provider business mailing address

10202 RUSTLING BIRCH RD APT 220
VERONA WI
53593-5137
US

V. Phone/Fax

Practice location:
  • Phone: 608-889-7500
  • Fax:
Mailing address:
  • Phone: 734-737-1711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number20310
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: