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General NPI Number Information
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NPI Number | 1003155334
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Entity Type | Organization
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Legal Business Name | KATHARINE WESTIE PHD PLLC
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Dates
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Enumeration Date | 02/06/2013
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 3537 W FRONT ST SUITE F
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-7941
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Country | US
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Telephone | 231-632-4282
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 543
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City | GLEN ARBOR
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State | MI
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Zip | 49636-0543
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Country | US
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Telephone | 231-632-4282
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATHARINE WESTIE
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Credential | PHD
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Telephone | 231-632-4282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301015141
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License Number State | MI
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