Provider Demographics
NPI:1083859623
Name:PARKINSON, KATHLEEN (MS)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:PARKINSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 HALL AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-1655
Mailing Address - Country:US
Mailing Address - Phone:715-732-7699
Mailing Address - Fax:715-732-7711
Practice Address - Street 1:2500 HALL AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-1655
Practice Address - Country:US
Practice Address - Phone:715-732-7699
Practice Address - Fax:715-732-7711
Is Sole Proprietor?:No
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)