Provider Demographics
NPI:1003155334
Name:KATHARINE WESTIE PHD PLLC
Entity Type:Organization
Organization Name:KATHARINE WESTIE PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHARINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTIE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:231-632-4282
Mailing Address - Street 1:PO BOX 543
Mailing Address - Street 2:
Mailing Address - City:GLEN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49636-0543
Mailing Address - Country:US
Mailing Address - Phone:231-632-4282
Mailing Address - Fax:
Practice Address - Street 1:3537 W FRONT ST
Practice Address - Street 2:SUITE F
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7941
Practice Address - Country:US
Practice Address - Phone:231-632-4282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015141103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty