Healthcare Provider Details

I. General information

NPI: 1700913811
Provider Name (Legal Business Name): KATHLEEN MULLIN HOAR PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 N. FRONT ST.
ROCHESTER WI
53167
US

IV. Provider business mailing address

PO BOX 344
ROCHESTER WI
53167-0344
US

V. Phone/Fax

Practice location:
  • Phone: 262-215-6905
  • Fax: 262-514-2835
Mailing address:
  • Phone: 262-215-6905
  • Fax: 262-514-2835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number1726
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1726
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1726
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1726
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: