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General NPI Number Information
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NPI Number | 1699100222
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Entity Type | Organization
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Legal Business Name | KATHERINE M. MCGUIRE, PSY.D. PLLC
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Dates
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Enumeration Date | 09/13/2013
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Last Update Date | 09/16/2013
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Provider Practice Location Address
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Address Line | 245 E CHEYENNE MOUNTAIN BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-3719
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Country | US
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Telephone | 719-229-1172
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Fax | 719-344-9179
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Provider Business Mailing Address
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Address Line | 4197 DOUGLASS WAY
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City | USAF ACADEMY
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State | CO
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Zip | 80840-1099
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Country | US
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Telephone | 719-229-1172
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Fax | 719-344-9179
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. KATHERINE MARIA MCGUIRE
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Credential | PSY.D.
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Telephone | 719-229-1172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 3605
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License Number State | CO
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