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NPI Code Detail

MEDICARE: MRS. KATHERINE GRACE FLINN LCSW

MEDICARE:  MRS. KATHERINE GRACE FLINN  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker84938CA

General Provider Information

NPI Number : 1306495882
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHERINE GRACE FLINN LCSW
Provider Business Mailing Address
First Line : 1622 4TH ST
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-4020
Country : US
Telephone Number : 707-200-7885
Fax Number :
Provider Business Practice Location Address
First Line : 1622 4TH ST
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-4020
Country : US
Telephone Number : 714-488-4497
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2019
Last Update Date : 06/07/2022

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Directions to “ MRS. KATHERINE GRACE FLINN LCSW” Practice Location

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