Provider Demographics
NPI:1235533357
Name:MOTZ, KATIE (CHHC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:MOTZ
Suffix:
Gender:F
Credentials:CHHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LITTLE CT
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-2722
Mailing Address - Country:US
Mailing Address - Phone:908-577-2445
Mailing Address - Fax:
Practice Address - Street 1:5 LITTLE CT
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2722
Practice Address - Country:US
Practice Address - Phone:908-577-2445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ137873305174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator