Healthcare Provider Details

I. General information

NPI: 1306783964
Provider Name (Legal Business Name): KATHERINE CHARLOTTE PALTELL PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 JOHN Q HAMMONS DR STE 101
MADISON WI
53717-2911
US

IV. Provider business mailing address

1221 JOHN Q HAMMONS DR STE 101
MADISON WI
53717-2911
US

V. Phone/Fax

Practice location:
  • Phone: 608-294-6088
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number5507-57
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: