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General NPI Number Information
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NPI Number | 1245821644
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Entity Type | Individual
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Provider Name | KATHRYN ROSSETTO FRUTIGER LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/28/2021
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 4005 TAMARACK CREEK RD
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City | WHITEFISH
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State | MT
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Zip | 59937-7139
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Country | US
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Telephone | 907-202-0126
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5318
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City | WHITEFISH
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State | MT
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Zip | 59937-5318
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Country | US
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Telephone | 907-202-0126
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | BBH-LCSW-LIC-48179
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 199825
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License Number State | AK
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