Provider Demographics
NPI:1275023285
Name:OLUND, KAITE
Entity Type:Individual
Prefix:
First Name:KAITE
Middle Name:
Last Name:OLUND
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 1:112 WATSON ST
Mailing Address - Street 2:
Mailing Address - City:RIPON
Mailing Address - State:WI
Mailing Address - Zip Code:54971-1327
Mailing Address - Country:US
Mailing Address - Phone:920-896-0189
Mailing Address - Fax:
Practice Address - Street 1:112 WATSON ST.
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:WI
Practice Address - Zip Code:54791
Practice Address - Country:US
Practice Address - Phone:920-896-0189
Practice Address - Fax:920-239-6021
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health