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General NPI Number Information
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NPI Number | 1285804757
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Entity Type | Individual
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Provider Name | KATHERINE RUTH PIERSON FRUHAUFF PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 12/05/2018
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Provider Practice Location Address
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Address Line | 2530 CRAWFORD AVE STE 104
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City | EVANSTON
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State | IL
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Zip | 60201-4954
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Country | US
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Telephone | 224-408-0019
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Fax | 855-217-0165
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Provider Business Mailing Address
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Address Line | 2530 CRAWFORD AVE STE 104
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City | EVANSTON
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State | IL
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Zip | 60201-4954
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Country | US
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Telephone | 224-408-0019
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Fax | 855-217-0165
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071007441
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License Number State | IL
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