Provider Demographics
NPI:1174009443
Name:PIUTA, KATIE ELIZABETH
Entity Type:Individual
Prefix:MISS
First Name:KATIE
Middle Name:ELIZABETH
Last Name:PIUTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 SWEETBERRY PASS WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-2517
Mailing Address - Country:US
Mailing Address - Phone:704-654-0155
Mailing Address - Fax:
Practice Address - Street 1:10926 DAVID TAYLOR DR STE 120
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-0039
Practice Address - Country:US
Practice Address - Phone:877-262-2221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician