Provider Demographics
NPI:1174199277
Name:STINE, KATHARINE (LBS)
Entity Type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:
Last Name:STINE
Suffix:
Gender:F
Credentials:LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 CAMPBELL CT
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-8894
Mailing Address - Country:US
Mailing Address - Phone:717-875-8330
Mailing Address - Fax:
Practice Address - Street 1:169 CAMPBELL CT
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-8894
Practice Address - Country:US
Practice Address - Phone:717-875-8330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH005386103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst