MEDICARE: KATHERINE FIELDS

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
1	101YP2500X	Professional Counselor	85906	TX

General Provider Information

NPI Number	:	1699487645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE FIELDS

Provider Business Mailing Address
First Line	:	2338 W ROSEDALE ST S
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76110-1136
Country	:	US
Telephone Number	:	512-696-3457
Fax Number	:

Provider Business Practice Location Address
First Line	:	2338 W ROSEDALE ST S
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76110-1136
Country	:	US
Telephone Number	:	512-696-3457
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2022
Last Update Date	:	12/21/2022

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Directions to “ KATHERINE FIELDS ” Practice Location

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