Provider Demographics
NPI:1255685335
Name:TINKER, KATHERINE (LPA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:TINKER
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 SE MAYNARD RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4164
Mailing Address - Country:US
Mailing Address - Phone:919-371-2848
Mailing Address - Fax:
Practice Address - Street 1:340 COMMERCE AVE STE 1
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-7115
Practice Address - Country:US
Practice Address - Phone:910-688-3646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst