Healthcare Provider Details

I. General information

NPI: 1306004551
Provider Name (Legal Business Name): KATHERINE PUTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 09/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 W. SCHROCK RD
WESTERVILLE OH
43081
US

IV. Provider business mailing address

899 E BROAD ST 3RD FLOOR
COLUMBUS OH
43205-1156
US

V. Phone/Fax

Practice location:
  • Phone: 614-355-8315
  • Fax: 614-355-8381
Mailing address:
  • Phone: 614-355-8000
  • Fax: 614-355-8018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-13-14673
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: