Healthcare Provider Details

I. General information

NPI: 1518125400
Provider Name (Legal Business Name): KATHERINE ANN PUCETA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHERINE ANN PUCETA PSY.D.

II. Dates (important events)

Enumeration Date: 05/28/2008
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 STARR SCHOOL RD
BROWNING MT
59417-2855
US

IV. Provider business mailing address

PO BOX 2855
BROWNING MT
59417-2855
US

V. Phone/Fax

Practice location:
  • Phone: 406-450-2432
  • Fax: 406-338-5369
Mailing address:
  • Phone: 406-450-2432
  • Fax: 406-338-5369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number388
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: