Healthcare Provider Details

I. General information

NPI: 1558502500
Provider Name (Legal Business Name): KATHERINE ANNE PIERATT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2009
Last Update Date: 03/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 S SANGAMON ST APT 7E
CHICAGO IL
60607-3538
US

IV. Provider business mailing address

411 S SANGAMON ST APT 7E
CHICAGO IL
60607-3538
US

V. Phone/Fax

Practice location:
  • Phone: 740-606-6506
  • Fax:
Mailing address:
  • Phone: 740-606-6506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number2336390
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberOH1251267
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: