Provider Demographics
NPI:1326261140
Name:CLEMENTS, KATHERINE (ND, LMT)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:ND, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5531 MARQUESAS CIR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3332
Mailing Address - Country:US
Mailing Address - Phone:941-951-6820
Mailing Address - Fax:941-927-2615
Practice Address - Street 1:5531 MARQUESAS CIR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-3332
Practice Address - Country:US
Practice Address - Phone:941-951-6820
Practice Address - Fax:941-927-2615
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1308175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath